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Chen LX, Peng SL, Mao LP, Luo XW, He Q, Xiang JH, Long FJ, Jiao Y. The Application of Self-Made Disseminating and Descending Breathing Exercises in Home Rehabilitation of Stable COPD. COPD 2024; 21:2369541. [PMID: 39087240 DOI: 10.1080/15412555.2024.2369541] [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] [Received: 07/12/2023] [Revised: 05/21/2024] [Accepted: 06/11/2024] [Indexed: 08/02/2024]
Abstract
To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group (n = 35) and the control group (n = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group (p < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group (p < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group (p < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.
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Affiliation(s)
- Ling-Xiu Chen
- Department of Respiratory and Critical Care Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Shu-Lei Peng
- Department of Sleep Medical Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Liang-Ping Mao
- Department of Respiratory and Critical Care Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Xin-Wei Luo
- Department of Respiratory and Critical Care Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Qian He
- Department of Respiratory and Critical Care Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Jian-Hua Xiang
- Department of Respiratory and Critical Care Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Fu-Juan Long
- Department of Pediatrics, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Yan Jiao
- Department of Respiratory and Critical Care Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
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Goh RWY, Chan GJY, Mohammad Hanip LA, Kwok BC. Concurrent Validity of Abbreviated Walk Tests Among Adults With Mild to Moderate Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13304. [PMID: 39343734 DOI: 10.1111/jar.13304] [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] [Received: 04/05/2024] [Revised: 09/07/2024] [Accepted: 09/15/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Walk tests are common gait speed and endurance assessments. Shorter test versions could benefit adults with intellectual disability. Thus, the concurrent validity of shorter tests was studied. METHODS Thirty-five adults with mild to moderate intellectual disability, aged 21-64 years, were assessed with the 4-m walk test, 10-m walk test for gait speed, 2-min walk test, and 6-min walk test for endurance. Correlation and Bland-Altman plots analyses were used to establish concurrent validity between shorter and standard tests. RESULTS Strong positive relationships were found for gait speed tests, r = 0.94, p < 0.001, and endurance tests, r = 0.83, p < 0.001, and differences between shorter and standard tests were within limits of agreement. CONCLUSIONS The concurrent validity of shorter walk tests was established in this study. This would mean that adults with intellectual disability with lower levels of fitness could be assessed. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry: ACTRN12624000203550.
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Affiliation(s)
- Rena Wen Yi Goh
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | - Gideon Ji Yan Chan
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | | | - Boon Chong Kwok
- Health and Social Sciences, Singapore Institute of Technology, Singapore
- Rehabilitation Services, Clinical Pilates Family Physiotherapy, Singapore
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Hanada M, Nonoyama T, Ikeuchi T, Sasaki K, Suyama K, Nakashita M, Shiroishi R, Segawa R, Tanaka K, Aoki H, Kitagawa C, Hori Y, Hashimoto S, Matsuzaki T, Sato S, Arizono S, Tanaka T, Kozu R. Feasibility of a problem-solving exercise program based on short physical performance battery for older patients with chronic respiratory diseases: A multicenter, pilot clinical trial. Respir Investig 2024; 62:1117-1123. [PMID: 39362179 DOI: 10.1016/j.resinv.2024.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 09/25/2024] [Accepted: 09/29/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND This study aimed to assess the feasibility and safety of a problem-solving exercise program based on the items in the short physical performance battery (SPPB) for older patients with chronic respiratory diseases (CRDs) to inform future randomized controlled trials. METHODS This was a multicenter, prospective, non-randomized feasibility study. Participants with CRD received an enhancement program based on the SPPB decline items (balance, walk, and/or chair stand) for 4 weeks. The feasibility, safety, and efficacy of the problem-solving exercise program in improving the SPPB score, physical function, and step count (measured using a pedometer) were assessed. RESULTS Overall, 36 patients were enrolled in this study, and adherence to the exercise program was high (100%). No exercise program-related adverse events were observed. The implementation of the exercise program ranged from 70 to 100%. The mean daily step count increased from 2152 ± 1498 steps during the first week to 2899 ± 1865 steps in the last week (p<0.01). Additionally, the SPPB total score increased from 8.9 ± 1.8 points to 10.7 ± 1.3 points at the end of the program (p<0.001). CONCLUSIONS The problem-solving exercise program based on SPPB is feasible and safe for older patients with CRDs. However, the effectiveness of this exercise program should be validated in large-scale, randomized-controlled trials in the future. TRIAL REGISTRATION University Hospital Medical Information Network Center (UMIN-CTR) UMIN: approval number: UMIN000048761.
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Affiliation(s)
- Masatoshi Hanada
- Department of Rehabilitation Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan; Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Tadayoshi Nonoyama
- Department of Rehabilitation Medicine, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Fukui, Japan
| | - Tomoyuki Ikeuchi
- Department of Rehabilitation Medicine, Kirigaoka Tsuda Hospital, 3-9-20 Kirigaoka, Kitakyusyu, Fukuoka, Japan
| | - Koki Sasaki
- Department of Rehabilitation Medicine, Hayashi Hospital, 1-3-5 Futyu, Echizen, Fukui, Japan
| | - Kazuaki Suyama
- Department of Rehabilitation Medicine, Tagami Hospital, 2-14-15 Tagami, Nagasaki, Japan
| | - Masaki Nakashita
- Department of Rehabilitation Medicine, JCHO Fukui Katsuyama General Hospital, 2-6-21 Nagayamacho, Katsuyama, Fukui, Japan
| | - Ryota Shiroishi
- Department of Rehabilitation Medicine, Utsunomiya Hospital, 2-1-7 Mikasagawa, Onojyo, Fukuoka, Japan
| | - Ryosuke Segawa
- Department of Rehabilitation Medicine, Sasebo City General Hospital, 9-3 Hirase-cho, Sasebo, Nagasaki, Japan
| | - Kengo Tanaka
- Department of Rehabilitation Medicine, Fukui Kosei Hospital, 1-6-1 Shimorokujyo, Fukui, Japan
| | - Hideki Aoki
- Department of Rehabilitation Medicine, Nagasaki Memorial Hospital, 1-11-54 Fukahori, Nagasaki, Japan
| | - Chika Kitagawa
- Department of Rehabilitation Medicine, Nagasaki Pulmonary Rehabilitation Clinic, 1694, Kaizu-cho, Isahaya, Nagasaki, Japan
| | - Yuichi Hori
- Department of Rehabilitation Medicine, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Japan
| | - Shuhei Hashimoto
- Department of Rehabilitation Medicine, Inoue Hospital, 6-12 Takaramachi, Nagasaki, Japan
| | - Toshiro Matsuzaki
- Department of Rehabilitation Medicine, Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Morimachi, Nagasaki, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakaomoto, Nagasaki, Japan
| | - Shinichi Arizono
- School of Health Sciences, Seirei Christopher University, 3453 Mikatahara, Hamamatsu, Shizuoka, Japan
| | - Takako Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Ryo Kozu
- Department of Rehabilitation Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan; Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan
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Zha S, Liu X, Yao Y, He Y, Wang Y, Zhang Q, Zhang J, Yi Y, Xiao R, Hu K. Short-term intermittent hypoxia exposure for dyspnea and fatigue in post-acute sequelae of COVID-19: A randomized controlled study. Respir Med 2024; 232:107763. [PMID: 39127085 DOI: 10.1016/j.rmed.2024.107763] [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: 03/07/2024] [Revised: 06/20/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Post-acute sequelae of COVID-19 (PASC) is incurring a huge health and economic burden worldwide. There is currently no effective treatment or recommended drug for PASC. METHODS This prospective randomized controlled study was conducted in a hospital in China. The effect of intermittent hypoxia exposure (IHE; 5-min hypoxia alternating with 5-min normal air, repeated five times) on dyspnea and fatigue was investigated in patients meeting the NICE definition of PASC. Patients were computationally randomized to receive normoxia exposure (NE) and routine therapy or IHE and routine therapy. Six-minute walk distance (6MWD) and spirometry were tested before and after the interventions; the Borg Dyspnea Scale (Borg) and the modified Medical Research Council Dyspnea Scale (mMRC) were used to assess dyspnea; and the Fatigue Assessment Scale (FAS) and the Chalder Fatigue Scale-11 (CFQ-11) were used to assess fatigue. The study was registered in the Chinese Clinical Trial Registry (ChiCTR2300070565). FINDINGS Ninety-five participants (33 males and 62 females) were recruited between March 1, 2023 and December 30, 2023. Forty-seven patients in the IHE group received 10.0 (9.0, 15.0) days of IHE, and 48 patients in NE group received 10.0 (8.0, 12.0) days of NE. 6MWD, forced vital capacity (FVC), FVC %pred, forced expiratory volume in 1 s (FEV1), FEV1 %pred, tidal volume (VT), and dyspnea and fatigue scales markedly improved after IHE (p < 0.05), and improvements were greater than in the NE group (all p < 0.05). Furthermore, participants in IHE group had better subjective improvements in dyspnea and fatigue than those in the NE group (p < 0.05). Compared with <10 days of IHE, ≥10 days of IHE had a greater impact on 6MWD, FVC, FEV1, FEV1 %pred, VT, FAS, and CFQ-11. No severe adverse events were reported. INTERPRETATION IHE improved spirometry and 6MWD and relieved dyspnea and fatigue in PASC patients. Larger prospective studies are now needed to verify these findings.
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Affiliation(s)
- Shiqian Zha
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xu Liu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yan Yao
- Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yang He
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yixuan Wang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qingfeng Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingyi Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yaohua Yi
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China; Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Rui Xiao
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China; Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Muñoz Montiel A, Ruiz-Esteban P, Doménech Del Río A, Valdivielso P, Sánchez Chaparro MÁ, Olveira C. The effect of pulmonary rehabilitation on cardiovascular risk, oxidative stress and systemic inflammation in patients with COPD. Respir Med 2024; 232:107740. [PMID: 39009098 DOI: 10.1016/j.rmed.2024.107740] [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: 03/22/2024] [Revised: 06/25/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is a leading cause of death, and cardiovascular (CV) comorbidities play a role. Evidence of the pulmonary rehabilitation (PR) effect in reducing the CV risk (CVR) in COPD patients is limited. In this study, we aimed to determine the impact of an 8-week PR program (PRP) on the CVR of the overall population and to compare the impact on the exacerbator versus non-exacerbator patients. PATIENTS AND METHODS This was a prospective study that included adults who had post-bronchodilator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) (FEV1/FVC) ratio <70 % and FEV1 <80 % predicted, had quit smoking for at least 1 year and had a history of tobacco consumption greater than 10 packs/year, and were clinically stable in the last 8 weeks. Pre- and post-PRP assessments included respiratory function evaluation, laboratory tests, and exercise capacity assessment (6-min walking test [6MWT]). CVR was assessed using different risk prediction models. RESULTS A total of 50 patients (28 exacerbators and 22 non-exacerbators) completed the PRP (median age: 64.5 years, men: 72 %; arterial hypertension: 70 %, dyslipidemia: 30 %, diabetes: 20 %; CV disease (CVD): 24 %. After the PRP, exacerbator patients showed a significant decrease in the CVR calculated by the COPDCoRi model (p < 0.001); patients with ≥30-m increase on the 6MWT showed statistically significant lower levels of glucose (p = 0.004), HbA1c (p = 0.004) and BODE index score (p = 0.026) compared to patients with <30-m increase. CONCLUSIONS PR reduced certain modifiable CVR factors and CVD risk, especially in exacerbator patients.
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Affiliation(s)
- Ana Muñoz Montiel
- Pulmonology Service/Unit, Monographic COPD Consultation. Regional University Hospital of Malaga, Malaga, Spain
| | - Pedro Ruiz-Esteban
- Nephrology Department, Regional University Hospital of Malaga, University of Malaga, The Biomedical Research Institute of Malaga (IBIMA), RICORS2040 (RD21/0005/0012), Malaga, Spain.
| | - Adolfo Doménech Del Río
- Pulmonology Service/Unit, Monographic COPD Consultation. Regional University Hospital of Malaga, Malaga, Spain
| | - Pedro Valdivielso
- Laboratory of Lipids and Atherosclerosis, Medico-Sanitarias Research Center (IBIMA), University of Malaga, Malaga, Spain; Internal Medicine, University Hospital Virgen de la Victoria, Department of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), Platform Bionand. University of Malaga, Malaga, Spain
| | - Miguel Ángel Sánchez Chaparro
- Internal Medicine, University Hospital Virgen de la Victoria, Department of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), Platform Bionand. University of Malaga, Malaga, Spain
| | - Casilda Olveira
- Department of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), Platform Bionand. University of Malaga, Malaga, Spain
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Visser S, Lawler C, Fermoyle CC, Spencer LM, McAnulty AJ, Alison JA, Webster S, Troy L, Jo H, Hayen A, Corte TJ. The 1-min sit-to-stand test as a screening tool to assess exercise-induced oxygen desaturation in normoxemic people with interstitial lung disease. Respir Med 2024; 232:107748. [PMID: 39074595 DOI: 10.1016/j.rmed.2024.107748] [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: 02/01/2024] [Revised: 07/26/2024] [Accepted: 07/26/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND In patients with interstitial lung disease (ILD), exercise-induced desaturation during the 6-min walk test (6MWT), specifically nadir oxygen saturation (nSpO2) of ≤88 % is a negative prognostic marker. As the 6MWT is often impractical for ILD patients, the aim of this study is to compare the 1-min sit-to-stand test (1minSTS) with the 6MWT to detect exercise-induced desaturation. METHODS Participants were recruited from a tertiary referral clinic with both tests performed on the same day. Utilising Bland-Altman analysis, the relationship between nSpO2 on 1minSTS and 6MWT was determined. An area under the receiver operating characteristic curve (AUC) determined the ability of nSpO2 on 1minSTS test to predict SpO2 ≤88 % on 6MWT. RESULTS Fifty participants completed the study (idiopathic pulmonary fibrosis n = 24, 48 %; connective tissue disease associated ILD n = 20, 40 %; other ILD n = 6, 12 %). Mean (SD) FVC%pred was 73 ± 16 %, mean DLCO%pred 57 ± 16 % and resting SpO2 99 ± 1 %. The 1minSTS resulted in less exercise-induced oxygen desaturation, with a median IQR nSpO2 of 95 % (89-98) and 93 % (85-96) respectively (p < 0.001). Moderate agreement was determined between the nSpO2 on both tests, with a mean difference of 3.2 % [-14 to +3.0 %]. The 1minSTS test accurately identified participants with nSpO2 ≤88 % on 6MWT (AUC 0.96). Oxygen desaturation ≤94 % during the 1minSTS test provided 100 % sensitivity and 87 % specificity for oxygen desaturation ≤88 % at 6MWT. CONCLUSION This study demonstrates that exercise-induced oxygen desaturation during the 1minSTS test correlates with oxygen desaturation on 6MWT. The 1minSTS may be a practical screening tool for ILD patients who would benefit from further exercise testing.
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Affiliation(s)
- Simone Visser
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney, Australia.
| | - Chloe Lawler
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney, Australia; Centre of Research Excellence in Pulmonary Fibrosis, Australia
| | - Caitlin C Fermoyle
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney, Australia; Centre of Research Excellence in Pulmonary Fibrosis, Australia
| | - Lissa M Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia
| | - Amanda J McAnulty
- Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia
| | - Jennifer A Alison
- University of Sydney, Faculty of Medicine and Health, Sydney, Australia; Allied Health, Sydney Local Health District, Sydney, Australia
| | - Susanne Webster
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Lauren Troy
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney, Australia; Centre of Research Excellence in Pulmonary Fibrosis, Australia
| | - Helen Jo
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Andrew Hayen
- School of Public Health, University of Technology Sydney, Sydney, Australia
| | - Tamera J Corte
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney, Australia; Centre of Research Excellence in Pulmonary Fibrosis, Australia
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Sari F, Pala GG, Oskay D, Tufan A. Investigating physical inactivity and associated health parameters in patients with systemic lupus erythematosus. Lupus 2024; 33:1168-1175. [PMID: 39120489 DOI: 10.1177/09612033241273078] [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: 08/10/2024]
Abstract
BACKGROUND Physical inactivity, which is highly prevalent in patients with systemic lupus erythematosus (SLE), is an independent risk factor for cardiovascular events and causes many complications. This study aimed to investigate the effect of objective measurement and physical activity level on peripheral muscle strength, exercise capacity, pain, dyspnea, fatigue, anxiety, and depression in patients with SLE. METHODS The present cross-sectional study analyzed 41 patients with SLE. Clinical and demographic characteristics of patients were recorded. Functional exercise capacity, peripheral muscle strength, dyspnea, pain, fatigue, anxiety, and depression were assessed. The physical activity level was assessed by a wearable activity tracker (Mi Band four smart band). RESULTS The number of steps measured by the activity tracker was 4384.43 ± 1558.21 steps per day in patients with SLE. Patients with physical activity levels below 5000 steps exhibited elevated levels of fatigue, along with diminished functional exercise capacity and knee muscle strength, in comparison to those who were above the 5000-step threshold. Physical activity levels correlated with functional exercise capacity (6MWT), physiological parameters (maximum heart rate, Δ heart rate, Δ dyspnea, QFM fatigue, Δ QFM fatigue), and knee extension muscle strength. The functional exercise capacity and knee extension were identified as significantly and dependently associated with physical activity levels in SLE patients. CONCLUSION Physical activity level is associated with functional exercise capacity and knee muscle strength in patients with SLE.
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Affiliation(s)
- Fulden Sari
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Bingol University, Bingol, Turkey
| | - Gamze Gülsün Pala
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Abdurrahman Tufan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Tylutka A, Morawin B, Torz N, Osmólska J, Łuszczki K, Jarmużek P, Zembron-Lacny A. Association of adipose tissue inflammation and physical fitness in older adults. Immun Ageing 2024; 21:64. [PMID: 39342343 PMCID: PMC11438273 DOI: 10.1186/s12979-024-00468-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 09/06/2024] [Indexed: 10/01/2024]
Abstract
An active lifestyle is of key importance for reduction of obesity and inflammation, as well as circulating levels of adipokines. Therefore, the aim of our study was to assess the relationship of physical fitness with chronic inflammatory status, and to evaluate biomarkers useful in the analysis of adipose tissue dysfunction. Sixty-three older adults (69.6 ± 5.1 years) were allocated to a high n = 31 (women n = 23 and men n = 8 male) or low physical fitness n = 32 (women n = 29 and men n = 3) group based on gait speed values (1.4-1.8 m/s or ≤ 1.3 m/s). The gait speed correlated with hand grip strength (rs = 0.493, p = 0.0001) and with leptin level (R = -0.372, p = 0.003), which shows the benefits of physical activity on muscle strength and circulating adipokines. In low physical fitness group, 58.1% individuals had adiponectin to leptin ratio (Adpn/Lep) < 0.5 revealing dysfunction of adipose tissue and high cardiometabolic risk; 20% of the group were obese with BMI ≥ 30 kg/m2. In high physical fitness group, 25.8% of individuals had Adpn/Lep ≥ 1.0 i.e., within the reference range. Markers of systemic inflammation were significantly related to physical fitness: CRP/gait speed (rs = -0.377) and HMGB-1/gait speed (rs = -0.264). The results of the ROC analysis for Adpn (AUC = 0.526), Lep (AUC = 0.745) and HMGB-1 (AUC = 0.689) indicated their diagnostic potential for clinical prognosis in older patients. The optimal threshold values corresponded to 1.2 μg/mL for Adpn (sensitivity 74.2%, specificity 41.9%, OR = 1.4, 95%Cl 0.488-3.902), 6.7 ng/mL for Lep (sensitivity 56.2%, specificity 93.5%, OR = 14.8, 95%Cl 3.574-112.229), 2.63 mg/L for CRP (sensitivity 51.6%, specificity 84.3%, OR = 4.4, 95% Cl 1.401- 16.063) and 34.2 ng/mL for HMGB-1 (sensitivity 62.0%, specificity 86.6%, OR = 12.0, 95%Cl 3.254-61.614). The highest sensitivity and specificity were observed for Leptin and HMGB-1. The study revealed changes in inflammatory status in older adults at various levels of physical fitness and demonstrated diagnostic usefulness of adipokines in the assessment of adipose tissue inflammation.
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Affiliation(s)
- Anna Tylutka
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 28 Zyty Str, Zielona Gora, 65-417, Poland
| | - Barbara Morawin
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 28 Zyty Str, Zielona Gora, 65-417, Poland
| | - Natalia Torz
- Student Research Group, University of Zielona Gora, Collegium Medicum University of Zielona Gora, 28 Zyty Str, Zielona Gora, 65-417, Poland
| | - Joanna Osmólska
- Student Research Group, University of Zielona Gora, Collegium Medicum University of Zielona Gora, 28 Zyty Str, Zielona Gora, 65-417, Poland
| | - Kacper Łuszczki
- Student Research Group, University of Zielona Gora, Collegium Medicum University of Zielona Gora, 28 Zyty Str, Zielona Gora, 65-417, Poland
| | - Paweł Jarmużek
- Department of Nervous System Diseases, Collegium Medicum University of Zielona Gora, Neurosurgery Center University Hospital in Zielona Gora, Zielona Gora, Poland
| | - Agnieszka Zembron-Lacny
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 28 Zyty Str, Zielona Gora, 65-417, Poland.
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Shen H, Xu Y, Zhang Y, Ren L, Chen R. Efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease and obstructive sleep apnea; a randomized controlled trial. J Rehabil Med 2024; 56:jrm23757. [PMID: 39318173 PMCID: PMC11439968 DOI: 10.2340/jrm.v56.23757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 08/22/2024] [Indexed: 09/26/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy of pulmonary rehabilitation in the outcomes of patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome patients who used positive airway pressure. DESIGN Prospective randomized controlled single- blind trial. PATIENTS A total of 79 patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome were randomly assigned to either the intervention group (n = 40) or control group (n = 39). METHODS All patients consistently adhered to positive airway pressure therapy every night from enrolment in the study, while intervention group patients received additional moderate-intensity aerobic exercise for 20 weeks. Pre- and post-intervention measurements included the 6-Minute Walk Test, Barthel Index, body mass index, fat mass, free fat mass, forced expiratory volume in 1 s (FEV1), FEV1%predicted, modified Medical Research Council, and polysomnography parameters. RESULTS After 20 weeks, the intervention group exhibited statistically significant improvements in 6MWD, Barthel Index, body mass index, fat mass, and modified Medical Research Council compared with control group (all p < 0.01). In addition, the intervention group showed a significantly lower percentage of total sleep time with oxygen saturation < 90% (p = 0.013) and higher lowest nocturnal oxygen saturation (p = 0.008) than the control group. However, there was no significant difference in FEV1 %predicted between the 2 groups. CONCLUSION Pulmonary rehabilitation incorporating moderate-intensity aerobic exercise could improve physical endurance and motor abilities in individuals with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome, while also improving anamnestic dyspnoea, body composition, and sleep-disordered breathing.
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Affiliation(s)
- Honghua Shen
- Department of Respiratory Rehabilitation, the Fourth Rehabilitation Hospital of Shanghai, Shanghai, China; Department of Respiratory and Critical Care Medicine, Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yiming Xu
- Department of Respiratory Rehabilitation, the Fourth Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Yin Zhang
- Department of Respiratory Rehabilitation, the Fourth Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Lei Ren
- Department of Respiratory Rehabilitation, the Fourth Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Rui Chen
- Department of Respiratory and Critical Care Medicine, Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou, China.
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10
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Fukushima T, Yamasaki M, Yamamoto N, Arima Y, Harino T, Hori S, Hashimoto Y, Kotsuka M, Inoue K, Hase K, Nakano J. Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer. BMJ Support Palliat Care 2024:spcare-2024-005100. [PMID: 39317427 DOI: 10.1136/spcare-2024-005100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 09/10/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES Preoperative management of oesophageal cancer requires effective prehabilitation. This study investigates the relationship between tongue pressure, respiratory muscle, handgrip and lower limb muscle strengths, and functional exercise capacity in patients with oesophageal cancer to develop a novel prehabilitation strategy. METHODS This prospective, single-centre, observational study analysed data from 29 pretreatment patients with oesophageal cancer. We evaluated tongue pressure, maximal inspiratory and expiratory pressures, handgrip and lower limb muscle strengths, functional exercise capacity and dysphagia scores before treatment. The relationship between parameters was identified using Spearman's correlation analysis. RESULTS Maximal inspiratory and expiratory pressures were significantly associated with handgrip and lower extremity muscle strengths and functional exercise capacity. However, tongue pressure was not associated with maximal inspiratory and expiratory pressures, handgrip and lower extremity muscle strengths and functional exercise capacity. Rather, tongue pressure was significantly associated with clinical T, dysphagia and nutritional status scores. CONCLUSIONS Respiratory muscle strength was associated with conventional sarcopenia and functional exercise capacity. Tongue pressure was not associated with respiratory muscle strength, conventional sarcopenia and functional exercise capacity. Rather, tongue pressure was associated with clinical T, dysphagia and nutritional status scores. Preoperative management of oesophageal cancer requires prehabilitation consisting of exercise and nutritional therapy and an additional swallowing programme, such as tongue resistance training, for patients without progress in oral intake, based on tongue pressure evaluation.
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Affiliation(s)
- Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Osaka, Japan
| | - Makoto Yamasaki
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Nobuyuki Yamamoto
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Yasuaki Arima
- Department of Rehabilitation, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - Takashi Harino
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Soshi Hori
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Yuki Hashimoto
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Masaya Kotsuka
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Kentaro Inoue
- Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Kimitaka Hase
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Hirakata, Osaka, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Osaka, Japan
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11
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Vardar-Yagli N, Saglam M, Firat M, Inal-Ince D, Calik-Kutukcu E, Kilic K, Arikan H, Coplu L. The Association Between Respiratory Functions, Pain Tolerance and Body Awareness in Obstructive Lung Diseases. Pain Manag Nurs 2024:S1524-9042(24)00238-8. [PMID: 39317562 DOI: 10.1016/j.pmn.2024.08.010] [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: 02/09/2024] [Revised: 08/06/2024] [Accepted: 08/18/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE There are only a limited number of studies in the literature evaluating body awareness, pain perception, and the relationship between clinical parameters and respiratory functions in patients with obstructive lung disease (OLD) and compared with healthy individuals. Therefore, this study aimed to evaluate respiratory functions, pain tolerance, and body awareness in patients with OLD and compare these findings with those of healthy individuals. METHODS The study included 33 patients and 30 healthy individuals. The respiratory function (spirometer), respiratory muscle strength (mouth pressure device), endurance (threshold loading device), pain level and tolerance (short-form McGill Pain Questionnaire and algometer), posture, and body awareness (Body Awareness Questionnaire-BAQ) were evaluated. RESULTS The pain threshold and tolerance of the biceps, triceps, trapezius, and quadriceps muscles were significantly lower and BAQ scores were higher in patients with OLD compared with healthy individuals (p < .05). There was a significant relationship between FEV1 (%) and pain tolerance of the triceps (r = 0.371, p = .047) and gastrocnemius muscles (r = 0.419, p = .024); FVC (%) and pain threshold of the gastrocnemius (r = 0.413, p = .023), triceps muscles (r = 0.394, p = .034), and pain tolerance of the gastrocnemius muscle (r = 0.549, p = .002). CONCLUSIONS Patients with OLD have a marked increase in pain perception and body awareness levels and a decrease in pain threshold and tolerance compared with healthy controls. Future studies should assess the effectiveness of pain management interventions as a part of pulmonary rehabilitation for patients with chronic respiratory diseases. CLINICAL IMPLICATIONS Pain management is important for planning pulmonary rehabilitation programmes.
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Affiliation(s)
- Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Firat
- Department of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Kubra Kilic
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hulya Arikan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Atilim University, Ankara, Turkey
| | - Lutfi Coplu
- Faculty of Medicine, Department of Chest Diseases, Hacettepe University, Ankara, Turkey
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12
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Figueira Silva BC, Abreu DC, Souza YR, Figueiredo M, Macêdo JF, Mafort TT, Rufino R, da Costa CH. Ultrasonography as a way of evaluating the diaphragm muscle in patients with chronic obstructive pulmonary disease. Medicine (Baltimore) 2024; 103:e39795. [PMID: 39312326 PMCID: PMC11419516 DOI: 10.1097/md.0000000000039795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/30/2024] [Indexed: 09/25/2024] Open
Abstract
The respiratory muscles in chronic obstructive pulmonary disease (COPD) patients have reduced strength and resistance, leading to loss of the functional ability of these muscles. Lung hyperinflation is one of the main alterations, and air trapping is the main factor limiting diaphragmatic mobility (DM) in these patients; however, its correlation with functional parameters, exercise capacity, and indicators of disease severity remains underexplored. This study aimed to assess DM in stable COPD patients and relate the findings with parameters such as the 6-minute walk test distance, forced expiratory volume in 1 second (FEV1) %predicted, residual volume (RV) %predicted, and dyspnea. An observational cohort study was conducted to measure DM using ultrasound both at rest (DMrest) and during deep inspiration (DMmax). Forty-nine patients with stable COPD were included in this study. There was a correlation between DMmax and FEV1 %predicted (R = 0.36; P = .012), RV %predicted (r = -0.42; P = .01), RV/total lung capacity (r = -0.61; P < .001), and distance reached in the 6MWT (R = 0.46; P = .001). Patients with a modified Medical Research Council score <2 exhibited greater DM than those with a score ≥2 (mean difference = 13.20 ± 4.6 mm; P = .0059). Similarly, patients with a Body Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity index ≤4 showed greater DM (61.95 mm) than those with a Body Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity index >4 (47.89 mm; mean difference = 14.05 ± 5.3 mm; 95% confidence interval = 25.09-3.01 mm). DM is correlated with bronchial obstruction (FEV1), lung hyperinflation (RV and RV/total lung capacity), exercise capacity, and dyspnea in patients with COPD, suggesting its utility as an evaluative tool in this population.
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13
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Abidi S, Ghram A, Ahmaidi S, Ben Saad H, Chlif M. Effects of Inspiratory Muscle Training on Stress Urinary Incontinence in North African Women: A Randomized Controlled Trial. Int Urogynecol J 2024:10.1007/s00192-024-05921-1. [PMID: 39276282 DOI: 10.1007/s00192-024-05921-1] [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: 06/07/2024] [Accepted: 08/10/2024] [Indexed: 09/16/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic floor muscles (PFMs) are involved in respiratory mechanisms. Additionally, stress urinary incontinence (SUI) can affect physical function. This randomized controlled trial was aimed at investigating the effects of inspiratory muscle training (IMT) on SUI severity, PFM function, and physical function in Tunisian women with SUI. METHODS Twenty-seven incontinent women were randomly assigned to either the experimental group or the control group. The following parameters were assessed: respiratory muscle strength (RMS; maximal inspiratory and expiratory pressures), SUI severity (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; pad test), PFM function (Modified Oxford Scale, electromyography, and endurance), and physical function (Timed Up & Go test; 6-min walk test; incremental shuttle walking test). IMT was conducted using threshold IMT. RESULTS The IMT program significantly reduced the severity of SUI (p < 0.01), improved PFM function (p < 0.001), enhanced physical function (p < 0.01), and increased RMS (p < 0.001). CONCLUSION Inspiratory muscle training could be an effective method for improving pelvic floor disorders and physical function in women with SUI.
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Affiliation(s)
- Sirine Abidi
- Research Laboratory Education, Motricity, Sport and Health LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
- Research Laboratory LR12SP09 «Heart Failure», University of Sousse, Farhat HACHED Hospital, Sousse, Tunisia
| | - Said Ahmaidi
- APERE, Exercise Physiology and Rehabilitation Laboratory, Picardie Jules Verne University, Sport Sciences Department, Avenue Paul Claudel, 80025, Amiens Cedex, France
| | - Helmi Ben Saad
- Research Laboratory LR12SP09 «Heart Failure», University of Sousse, Farhat HACHED Hospital, Sousse, Tunisia
| | - Mehdi Chlif
- APERE, Exercise Physiology and Rehabilitation Laboratory, Picardie Jules Verne University, Sport Sciences Department, Avenue Paul Claudel, 80025, Amiens Cedex, France
- Tunisian Research Laboratory "Sport Performance Optimization," National Center of Medicine and Science in Sport (CNMSS), Tunis, Tunisia
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14
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Wu DW, Yang PC, Lin IM. Effects of Heart Rate Variability (HRV) Biofeedback in Pulmonary Indicators and HRV Indices Among Patients with Chronic Obstructive Pulmonary Disease. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09664-z. [PMID: 39254863 DOI: 10.1007/s10484-024-09664-z] [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] [Accepted: 08/26/2024] [Indexed: 09/11/2024]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) exhibit reduced cardiac autonomic activity, linked to poor prognosis and exercise intolerance. While heart rate variability biofeedback (HRVB) can enhance cardiac autonomic activity in various diseases, its use in patients with COPD is limited. This study explored the impact of the HRVB on cardiac autonomic activity and pulmonary indicators in patients with COPD. Fifty-three patients with COPD were assigned to either the HRVB (n = 26) or the control group (n = 27), with both groups receiving standard medical care. The HRVB group also underwent one-hour HRVB sessions weekly for six weeks. All participants had pre- and post-test measurements, including the Six-Minute Walking Test (6MWT), lead II electrocardiogram (ECG) recording, Modified Medical Research Council Dyspnea Scale (mMRC), body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index. ECG data were analyzed for heart rate variability (HRV) as an index of cardiac autonomic activity. A two-way mixed analysis of variances demonstrated significant interaction effects of Group × Time in pulmonary indicators and HRV indices. The HRVB group exhibited significant post-test improvements, with decreased mMRC and BODE scores and increased 6MWT distance and HRV indices, compared to pre-test results. The 6MWT distance significantly increased and mMRC significantly decreased at post-test in the HRVB group compared with the control group. This study confirmed the efficacy of HRVB as an adjunct therapy in patients with COPD, showing improvements in exercise capacity, breathing difficulties, and cardiac autonomic activity.
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Affiliation(s)
- Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, 812, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Doctoral Degree Program, Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Po-Chou Yang
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, No.100, Chih-Chuan 1st road, Kaohsiung, 807, Taiwan
| | - I-Mei Lin
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, No.100, Chih-Chuan 1st road, Kaohsiung, 807, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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15
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Hinrichs T, Rantanen T, Portegijs E, Nebiker L, Rössler R, Schwendinger F, Schmidt-Trucksäss A, Roth R. Reliability and validity of the German version of the University of Jyvaskyla Active Aging Scale (UJACAS-G). J Patient Rep Outcomes 2024; 8:104. [PMID: 39256269 PMCID: PMC11387280 DOI: 10.1186/s41687-024-00786-w] [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] [Received: 03/14/2024] [Accepted: 09/06/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND The University of Jyvaskyla Active Aging Scale (UJACAS) assesses active aging through willingness, ability, opportunity, and frequency of involvement in activities. Recognizing the lack of a German version, the Finnish original was translated (UJACAS-G). This study aimed: (1) to evaluate the test-retest reliability of UJACAS-G; and (2) to explore correlations with health-related parameters (concurrent validity). METHODS The study (test-retest design) targeted healthy older adults aged 65+. Reliability of UJACAS-G (total and subscores) was assessed using Bland-Altman analyses and Intraclass Correlation Coefficients (ICCs). Furthermore, correlations (Spearman's rho) between UJACAS-G scores and physical function (walking speed, handgrip strength, balance, 6-minute walk distance), physical activity (International Physical Activity Questionnaire), life-space mobility (Life-Space Assessment), and health-related quality of life (Short Form-36 Health Survey) were calculated. RESULTS Bland-Altman analyses (N = 60; mean age 72.3, SD 5.9 years; 50% women) revealed mean differences close to zero and narrow limits of agreement for all scores (total score: mean difference -1.9; limits -31.7 to 27.9). The ability subscore showed clustering at its upper limit. ICC was 0.829 (95% CI 0.730 to 0.894) for the total score and ranged between 0.530 and 0.876 for subscores (all p-values < 0.001). The total score correlated with walking speed (rho = 0.345; p = 0.008), physical activity (rho = 0.279; p = 0.033) and mental health (rho = 0.329; p = 0.010). CONCLUSIONS UJACAS-G is reliable for assessing active aging among German-speaking healthy older adults. A potential 'ceiling effect' regarding the ability subscore should be considered when applying UJACAS-G to well-functioning populations. Analyses of concurrent validity indicated only weak correlations with health-related parameters.
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Affiliation(s)
- Timo Hinrichs
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, Basel, 4052, Switzerland.
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lukas Nebiker
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, Basel, 4052, Switzerland
| | - Roland Rössler
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, Basel, 4052, Switzerland
- Basel Mobility Center, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Fabian Schwendinger
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, Basel, 4052, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, Basel, 4052, Switzerland
| | - Ralf Roth
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, Basel, 4052, Switzerland
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16
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Salbach NM, Mayo NE, Webber SC, Jones CA, Lix LM, Ripat J, Grant T, van Ineveld C, Chilibeck PD, Romanescu RG, Scott S, Barclay R. Short-term effects of a park-based group mobility program on increasing outdoor walking in older adults with difficulty walking outdoors: the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial. BMC Geriatr 2024; 24:740. [PMID: 39243012 PMCID: PMC11378552 DOI: 10.1186/s12877-024-05331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 08/24/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND We estimated the short-term effects of an educational workshop and 10-week outdoor walk group (OWG) compared to the workshop and 10 weekly reminders (WR) on increasing outdoor walking (primary outcome) and walking capacity, health-promoting behavior, and successful aging defined by engagement in meaningful activities and well-being (secondary outcomes) in older adults with difficulty walking outdoors. METHODS In a 4-site, parallel-group randomized controlled trial, two cohorts of community-living older adults (≥ 65 years) reporting difficulty walking outdoors participated. Following a 1-day workshop, participants were stratified and randomized to a 10-week OWG in parks or 10 telephone WR reinforcing workshop content. Masked evaluations occurred at 0, 3, and 5.5 months. We modeled minutes walked outdoors (derived from accelerometry and global positioning system data) using zero-inflated negative binomial regression with log link function, imputing for missing observations. We modeled non-imputed composite measures of walking capacity, health-promoting behavior, and successful aging using generalized linear models with general estimating equations based on a normal distribution and an unstructured correlation matrix. Analyses were adjusted for site, participation on own or with a partner, and cohort. RESULTS We randomized 190 people to the OWG (n = 98) and WR interventions (n = 92). At 0, 3, and 5.5 months, median outdoor walking minutes was 22.56, 13.04, and 0 in the OWG, and 24.00, 26.07, and 0 in the WR group, respectively. There was no difference between groups in change from baseline in minutes walked outdoors based on incidence rate ratio (IRR) and 95% confidence interval (CI) at 3 months (IRR = 0.74, 95% CI 0.47, 1.14) and 5.5 months (IRR = 0.77, 95% CI 0.44, 1.34). Greater 0 to 3-month change in walking capacity was observed in the OWG compared to the WR group (βz-scored difference = 0.14, 95% CI 0.02, 0.26) driven by significant improvement in walking self-efficacy; other comparisons were not significant. CONCLUSIONS A group, park-based OWG was not superior to WR in increasing outdoor walking activity, health-promoting behavior or successful aging in older adults with difficulty walking outdoors; however, the OWG was superior to telephone WR in improving walking capacity through an increase in walking self-efficacy. Community implementation of the OWG is discussed. TRIAL REGISTRATION ClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017.
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Affiliation(s)
- Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
- The KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
| | - Nancy E Mayo
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Sandra C Webber
- Department of Physical Therapy, University of Manitoba, Winnipeg, MB, Canada
| | - C Allyson Jones
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jacquie Ripat
- Department of Occupational Therapy, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Razvan G Romanescu
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Susan Scott
- McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Ruth Barclay
- Department of Physical Therapy, University of Manitoba, Winnipeg, MB, Canada
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17
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Stavrou VT, Pitris K, Constantinidou F, Adamide T, Frangopoulos F, Bargiotas P. The impact of a 12-week tele-exercise program on cognitive function and cerebral oxygenation in patients with OSA: randomized controlled trial-protocol study. Front Sports Act Living 2024; 6:1418439. [PMID: 39346497 PMCID: PMC11427754 DOI: 10.3389/fspor.2024.1418439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/13/2024] [Indexed: 10/01/2024] Open
Abstract
Obstructive sleep apnea (OSA) is associated with a number of adverse health effects, particularly on brain health. Chronic sleep disruption caused by OSA can adversely affect cognitive health. Exercise is recommended as a non-pharmacological intervention for patients who are intolerant to continuous positive airway pressure (CPAP) and has been shown to have beneficial effects on brain health and cognitive function. This protocol aims to investigate the effects of a 12-week tele-exercise program on cognitive function and specific parameters of brain activity, including brain metabolism and oxygenation, in patients with OSA. The project aims to demonstrate the multidimensional relationship between exercise, cognition, and brain oxygenation/metabolism. Our local ethics committee has approved the study. Our population sample (Group A, OSA with cognitive impairment (CI) and tele-exercise; Group B, OSA with CI and no tele-exercise; Group C, OSA without CI and no tele-exercise) will undergo assessment both before and after a 12-week tele-exercise intervention program. This assessment will include a comprehensive battery of subjective and objective assessment tests. Data will be analyzed according to group stratification. We hypothesize a beneficial effect of tele-exercise on sleep and cognitive parameters, and we are confident that this study will raise awareness among healthcare professionals of the brain health benefits of exercise in patients with low compliance to CPAP treatment. The protocol of our manuscript entitled "The impact of a 12-week tele-exercise program on cognitive function and cerebral oxygenation in patients with OSA: Randomized Controlled Trial -Protocol Study" has been registered on ClinicalTrials.gov with ID NCT06467682.
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Affiliation(s)
- Vasileios T Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- RespiHub, ONISILOS MSCA COFUND, University of Cyprus, Nicosia, Cyprus
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Konstantinos Pitris
- Department of Electrical and Computer Engineering, KIOS Research and Innovation Center of Excellence, University of Cyprus, Nicosia, Cyprus
| | | | - Tonia Adamide
- Respiratory Clinic, General Hospital of Nicosia, Nicosia, Cyprus
| | | | - Panagiotis Bargiotas
- RespiHub, ONISILOS MSCA COFUND, University of Cyprus, Nicosia, Cyprus
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
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18
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Li Q, Huang F, Cheng Y, Dai Y, Lin Z, Lin Z, Zhu P. Does high-frequency resistance exercise offer additional benefits to older adults? learnings from a randomized controlled trial. BMC Sports Sci Med Rehabil 2024; 16:186. [PMID: 39243106 PMCID: PMC11378542 DOI: 10.1186/s13102-024-00975-6] [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: 06/25/2024] [Accepted: 08/27/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVE Resistance exercise is an effective strategy to improve muscle strength in older adults. A limited-load resistance would be flexible and suitable for community-based training. It was unclear whether high-frequency resistance exercise offer additional benefits to older adults. Here, we aimed to examine the effect of limited-load resistance exercise among different frequency on muscle parameters in older adults. METHODS The current study was a single-blind, randomized controlled trial comparing the effectiveness of different-frequency resistance exercise in older adults. Change in skeletal muscle was estimated with a multi-frequency bioelectrical impedance analyzer. Demographics, physical examination, nutritional assessment, prealbumin and lymphocytes were also measured. Fisher's precision probability test and baseline-adjusted generalized linear models were applied accordingly to analyze the influence of dose-different exercise on prevalence of sarcopenia, muscle parameters and body composition. A two-sided p value of < 0.05 was defined statistical significance. RESULTS The participants had a mean age of 71.96 years and close gender ratio. One hundred and twenty-seven participants (control 40; low-dose 46; high-dose 41) completed the 6-month exercise intervention. In contrast to control group, only high-dose exercise groups experienced improvements in muscle mass (0.66 kg, p < 0.001) and max grip strength (+ 2.17 kg, p < 0.001). There were significant dose-response effects of muscle mass (index), fat mass (index), max grip strength, 5-times sit to stand test, 6-minute walking test and visceral fat area (all ptrend <0.01). CONCLUSIONS As the proved dose-dependent effect, current findings supported high-frequency limited-load resistance exercise applied and extended among older adults in community. TRIAL REGISTRATION This study was registered at Chinese Clinical Trial Registry Network (ChiCTR2200062007, Registered on 19 July 2022).
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Affiliation(s)
- Qiaowei Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Key Laboratory of Geriatrics, Fuzhou, China
- Fujian Provincial Center for Geriatrics, Fuzhou, China
| | - Feng Huang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Key Laboratory of Geriatrics, Fuzhou, China
- Fujian Provincial Center for Geriatrics, Fuzhou, China
| | - Yanling Cheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yalan Dai
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Zhong Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Zhonghua Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
- Fuzhou University Affiliated Provincial Hospital, Fuzhou, China.
- Department of Rehabilitation Medicine, Fujian Provincial Hospital, Fuzhou, China.
| | - Pengli Zhu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
- Fuzhou University Affiliated Provincial Hospital, Fuzhou, China.
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China.
- Fujian Key Laboratory of Geriatrics, Fuzhou, China.
- Fujian Provincial Center for Geriatrics, Fuzhou, China.
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Bishop JA, Spencer LM, Dwyer TJ, McKeough ZJ, McAnulty A, Leung R, Alison JA. Effect of pulmonary rehabilitation duration on exercise capacity and health-related quality of life in people with chronic obstructive pulmonary disease (PuRe Duration Trial): A randomized controlled equivalence trial. Respirology 2024. [PMID: 39228164 DOI: 10.1111/resp.14820] [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: 03/10/2024] [Accepted: 08/13/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND AND OBJECTIVE There is no strong evidence on the optimal duration of pulmonary rehabilitation (PR) programmes. The aim of the study was to determine whether an 8-week PR programme was equivalent to a 12-week PR programme in improving endurance exercise capacity in people with chronic obstructive pulmonary disease (COPD). METHODS Participants with COPD were randomized to either an 8-week (8-wk Group) or 12-week (12-wk Group), twice weekly, supervised PR programme consisting of endurance and strength training and individualized self-management education. Between group comparisons were made at completion of each programme (i.e., week 8 or week 12), for both programmes at week 12, and at 6-12-month follow-up. The primary outcome was endurance exercise capacity measured by the endurance shuttle walk test (ESWT) with the minimally important difference of 186 s set as the equivalence limit. RESULTS Sixty-six participants [mean (SD); age 69 (7) years, FEV1 48 (17) %predicted] were randomized (33 per group). Between-group comparisons demonstrated that the ESWT time was equivalent for the 12-wk Group compared to the 8-wk Group at programme completion [mean (95% CI)] [71 s (-61 to 203)], week 12 [70 s (-68 to 208)], and 6-12-month follow-up [93 s (-52 to 239)], though superiority of the 12-wk Group could not be ruled out at each time point. CONCLUSION Equivalence was shown between 8-and 12-week PR programmes for endurance exercise capacity, but superiority could not be ruled out for the 12-wk Group. Decisions about programme duration may depend on local waitlist times, healthcare budgets and patient preference.
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Affiliation(s)
- Joshua A Bishop
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Physiotherapy, Balmain Hospital, Balmain, New South Wales, Australia
| | - Lissa M Spencer
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Tiffany J Dwyer
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Zoe J McKeough
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Amanda McAnulty
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Regina Leung
- Department of Respiratory Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Jennifer A Alison
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Allied Health, Sydney Local Health District, Sydney, Australia
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20
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Bishop JA, Spencer LM, Dwyer TJ, McKeough ZJ, McAnulty A, Cheng S, Alison JA. Patterns of physical activity of people with COPD during participation in a pulmonary rehabilitation program. Respir Med 2024; 231:107724. [PMID: 38971337 DOI: 10.1016/j.rmed.2024.107724] [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: 04/15/2024] [Revised: 06/11/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION Very few studies have examined patterns of physical activity (PA) during a pulmonary rehabilitation (PR) program in people with COPD. AIMS To compare the patterns of PA in: 1) the week before commencing PR (pre-PR) with a week during PR (PR week); 2) PR days and non-PR days during a PR week; 3) pre-PR and the week following PR completion (post-PR). METHODS This was a multicenter, prospective cohort study. Participants attended twice weekly supervised PR for 8-12 weeks. Daily step count (primary outcome), time in light activities, time in moderate to vigorous PA (MVPA), total sedentary time and sit-to-stand (STS) transitions were measured using a thigh worn accelerometer for seven days, at each assessment time point: pre-PR, PR week and post-PR. RESULTS 29 participants, mean age (SD) 69years(7), FEV1 53%pred(16). The PR week compared to pre-PR, showed higher daily: step count (mean difference (95%CI)), 941steps(388-1494); and MVPA, 11mins(6-15), with no difference in: time in light activities, -1min(-6-5); total sedentary time, 7mins(-21-36); or STS transitions, 0(-5-6). PR days compared to non-PR days showed higher: step count, 2810steps(1706-3913); time in light activities 11mins(1-20); time in MVPA, 27mins(17-35) and STS transitions, 8(4-12), with no difference in total sedentary time: -33mins(-80-15). There were no differences in any PA measures post-PR compared to pre-PR (p < 0.05). CONCLUSION Daily step count and time spent in MVPA increased significantly during the PR week, solely due to increased PA on days participants attended PR.
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Affiliation(s)
- Joshua A Bishop
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Department of Physiotherapy, Balmain Hospital, Balmain, Australia; Allied Health, Sydney Local Health District, Camperdown, Australia
| | - Lissa M Spencer
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, Australia; Allied Health, Sydney Local Health District, Camperdown, Australia
| | - Tiffany J Dwyer
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Zoe J McKeough
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Amanda McAnulty
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, Australia; Allied Health, Sydney Local Health District, Camperdown, Australia
| | - Sonia Cheng
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Jennifer A Alison
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Allied Health, Sydney Local Health District, Camperdown, Australia.
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21
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Diciolla NS, Rebelo P, Rodrigues G, Grave AS, Dias C, Gomes M, Santos ES, Pereira Z, Pereira L, Marques A. Validation of "CENTR(AR)" walking trails: Different field criteria do not lead to different physical activity intensities in people with COPD. Heart Lung 2024; 67:26-32. [PMID: 38640848 DOI: 10.1016/j.hrtlng.2024.04.014] [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] [Received: 01/23/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Validating walking trails is essential to promote physical activity (PA) safely and confidently in people with COPD. OBJECTIVES We aimed to validate predetermined light, moderate, and vigorous intensities of walking trails in people with COPD. METHODS This cross-sectional study included individuals with COPD walking in predetermined light, moderate and vigorous intensity trails. Activity intensity and volume outcomes were collected. Dyspnoea and fatigue (modified Borg scale), energy expenditure (EE, Sensewear), heart rate (HR, HR monitor), time spent in different PA intensities, and cadence (ActiGraph) were recorded and used to classify PA intensity. RESULTS Twenty people with COPD [71(7) years, 80 % male, FEV1%predicted 65.6(11.6)] were included. Fatigue differed significantly between light and moderate [3.0(2.0;4.0) vs 3.4(2.5;4.5), p = 0.01], but not vigorous (3.5[2.5-4.0]) tracks. Dyspnoea [2.3(1.5) vs 2.7(1.6) vs 2.6(1.4)], EE [5.1(0.8) vs 4.9(0.5) vs 4.6(0.8) METs], HR [92.5(11.1) vs 93.7(18.6) vs 95.4(15.0) beats/min] and cadence [115.1(104.0;120.3) vs 104.7(99.6;117.6) vs 111.2(99.9;118.5) steps/min] were similar across trails (p > 0.05). Time spent in light and moderate PA, EE volume, walking time, and step count increased along with the proposed intensity levels (p < 0.01). Walking trails were categorised as moderate intensity in most participants. CONCLUSION Walking trails were safe and valid for practising moderate-intensity PA in people with COPD. Participants adjusted their physiological responses and perceived symptoms to match a moderate intensity.
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Affiliation(s)
- Nicola S Diciolla
- Physiotherapy in Women's Health Research Group - FPSM, Department of Nursing and Physiotherapy, University of Alcalá, Alcalá de Henares, Madrid, Spain; Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Patrícia Rebelo
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Guilherme Rodrigues
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Ana Sofia Grave
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Cíntia Dias
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Maria Gomes
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - E Samuel Santos
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Zulmira Pereira
- Cosmonível Company - Topography, Cartography and Cadaster, Porto, Portugal.
| | - Luísa Pereira
- Águeda School of Technology and Management - ESTGA, University of Aveiro, Aveiro, Portugal.
| | - Alda Marques
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
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Guler SA, Marinescu DC, Cox G, Durand C, Fisher JH, Grant-Orser A, Goobie GC, Hambly N, Johannson KA, Khalil N, Kolb M, Lok S, MacIsaac S, Manganas H, Marcoux V, Morisset J, Scallan C, Shapera S, Sun K, Zheng B, Ryerson CJ, Wong AW. The Clinical Frailty Scale for Risk Stratification in Patients With Fibrotic Interstitial Lung Disease. Chest 2024; 166:517-527. [PMID: 38423280 DOI: 10.1016/j.chest.2024.02.043] [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] [Received: 01/12/2024] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Previous studies have shown the importance of frailty in patients with fibrotic interstitial lung disease (ILD). RESEARCH QUESTION Is the Clinical Frailty Scale (CFS) a valid tool to improve risk stratification in patients with fibrotic ILD? STUDY DESIGN AND METHODS Patients with fibrotic ILD were included from the prospective multicenter Canadian Registry for Pulmonary Fibrosis. The CFS was assessed using available information from initial ILD clinic visits. Patients were stratified into fit (CFS score 1-3), vulnerable (CFS score 4), and frail (CFS score 5-9) subgroups. Cox proportional hazards and logistic regression models with mixed effects were used to estimate time to death or lung transplantation. A derivation and validation cohort was used to establish prognostic performance. Trajectories of functional tests were compared using joint models. RESULTS Of the 1,587 patients with fibrotic ILD, 858 (54%) were fit, 400 (25%) were vulnerable, and 329 (21%) were frail. Frailty was a risk factor for early mortality (hazard ratio, 5.58; 95% CI, 3.64-5.76, P < .001) in the entire cohort, in individual ILD diagnoses, and after adjustment for potential confounders. Adding frailty to established risk prediction parameters improved the prognostic performance in derivation and validation cohorts. Patients in the frail subgroup had larger annual declines in FVC % predicted than patients in the fit subgroup (-2.32; 95% CI, -3.39 to -1.17 vs -1.55; 95% CI, -2.04 to -1.15, respectively; P = .02). INTERPRETATION The simple and practical CFS is associated with pulmonary and physical function decline in patients with fibrotic ILD and provides additional prognostic accuracy in clinical practice.
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Affiliation(s)
- Sabina A Guler
- Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Lung Precision Medicine (LPM), Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.
| | - Daniel-Costin Marinescu
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada
| | - Gerard Cox
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Celine Durand
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Jolene H Fisher
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Gillian C Goobie
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Nathan Hambly
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Nasreen Khalil
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Martin Kolb
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Stacey Lok
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sarah MacIsaac
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Helene Manganas
- Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Veronica Marcoux
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Julie Morisset
- Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Ciaran Scallan
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Shane Shapera
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kelly Sun
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Boyang Zheng
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Division of Rheumatology, McGill University, Montreal, QC, Canada
| | - Christopher J Ryerson
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada
| | - Alyson W Wong
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada
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Erkoç A, Eroğlu İ, Erbas T, Kutukcu EC. Muscle function, exercise capacity, physical activity level and cardiovascular disease risk factor knowledge in patients with prolactinoma. Endocrine 2024; 85:1337-1345. [PMID: 38801597 DOI: 10.1007/s12020-024-03880-7] [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: 03/15/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Prolactinoma can increase the risk of cardiovascular diseases (CVDs), such as arterial stiffness, atherosclerosis, dysrhythmia and heart failure. This study aimed to evaluate and compare muscle function, exercise capacity, physical activity (PA) level, CVD risk factor knowledge level, sleep quality, fatigue and quality of life between prolactinoma patients and healthy controls. METHODS Nineteen female patients with prolactinomas and 19 healthy women were included in this study. Quadriceps muscle strength (QMS) was measured using a hand dynamometer, and muscular endurance was evaluated via the squat test. The 6-minute walking test (6MWT) distance was also measured. CVD risk factor knowledge levels were evaluated with the Cardiovascular Diseases Risk Factors Knowledge Level Scale (CARRF-KL), PA levels were assessed with the International Physical Activity Questionnaire-short form (IPAQ), sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), fatigue was assessed with the Multidimensional Fatigue Rating Scale (MAF), and quality of life was assessed with the Short Form-36 questionnaire (SF-36). RESULTS Patients with prolactinomas had significantly lower 6MWT distances; CARRF-KL total scores; SF-36 general health and physical limitation scores; and higher IPAQ-sitting scores than did healthy controls (p < 0.05). Moreover, there were no significant differences between the groups in terms of QMS score; number of squats; severity of IPAQ score; severity, moderate, or total walking score; total PSQI score; or total MAF score (p > 0.05). CONCLUSIONS Exercise capacity and quality of life are adversely affected, and sedentary behavior is observed in prolactinomas. Patients with prolactinomas have less knowledge about CVD risk factors than healthy individuals. CVD incidence and knowledge and functional capacity should be improved in patients with prolactinomas by the use of a multidisciplinary team for cardiac rehabilitation. CLINICAL TRIAL REGISTRATION This study is part of a larger clinical trial registered on ClinicalTrials.gov prior to participant enrollment (NCT05236829).
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Affiliation(s)
- Ayşegül Erkoç
- Department of Cardiorespiratory Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100, Samanpazari, Ankara, Turkey.
| | - İmdat Eroğlu
- Department of Internal Medicine, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
| | - Tomris Erbas
- Department of Internal Medicine, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
| | - Ebru Calik Kutukcu
- Department of Cardiorespiratory Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100, Samanpazari, Ankara, Turkey
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Li J, Zhang H, Wang J, Lu X, Zuo M, Jiao L, Lu X, Wang Y. Efficacy and safety of Supine Daoyin in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial. J Evid Based Med 2024; 17:654-666. [PMID: 39322941 DOI: 10.1111/jebm.12650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 09/13/2024] [Indexed: 09/27/2024]
Abstract
AIM This study aimed to develop and evaluate the efficacy and safety of Supine Daoyin, a TCM PR technique, in hospitalized patients with AECOPD. METHODS This is a multicenter, prospective, randomized, controlled trial involving AECOPD inpatients recruited from April 2021 to December 2023 in five tertiary hospitals in China. Participants were randomly assigned to 14 days of Supine Daoyin group or control group and evaluated at days 3, 7, and 14 (posttreatment). The primary outcomes were LOS and CCQ and secondary outcomes were 6MWD, 30-STS, BI, Borg CR10, time on mechanical ventilation, SGRQ, mCOPD-PRO, and mESQ-COPD. RESULTS Out of 369 participants screened, 228 were randomly assigned (Supine Daoyin group: n = 114; control group: n = 114). For primary outcomes, there was no significant between-group difference in LOS (p > 0.05), but for CCQ the Supine Daoyin was superior to control at days 7 (p < 0.01) and 14 (p < 0.01). For secondary outcomes, Supine Daoyin groups showed robust and superior improvements in 6MWD, 30-STS, BI, Borg CR10, SGRQ, mCOPD-PRO, and mESQ-COPD (all p < 0.05), but for time on mechanical ventilation there was no significant difference in two groups (p > 0.05). CONCLUSION Supine Daoyin, a novel TCM PR technique, demonstrates safety and efficacy for AECOPD inpatients, yielding clinically meaningful improvements in health status, exercise capacity, and quality of life. This study offers a viable PR option for AECOPD patients with severe symptoms and limited mobility.
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Affiliation(s)
- Jiansheng Li
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases coconstructed by Henan province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Hailong Zhang
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases coconstructed by Henan province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jun Wang
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases coconstructed by Henan province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xuechao Lu
- Department of Respiratory and Critical Care Medicine, Qingdao Traditional Chinese Medicine Hospital (Qingdao Hiser Hospital) Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, China
| | - Mingyan Zuo
- Department of Respiratory and Critical Care Medicine, Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang, China
| | - Li Jiao
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaofan Lu
- Department of Respiratory and Critical Care Medicine, Henan Province Hospital of TCM, Zhengzhou, China
| | - Yang Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Vilarinho R, Montes AM, Noites A, Silva F, Melo C. Reference values for the 1-minute sit-to-stand and 5 times sit-to-stand tests to assess functional capacity: a cross-sectional study. Physiotherapy 2024; 124:85-92. [PMID: 38875841 DOI: 10.1016/j.physio.2024.01.004] [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] [Received: 12/29/2022] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES To establish age-specific and sex-specific reference values and equations for the 1-minute sit-to-stand (1MSTS) and 5 times sit-to-stand (5TSTS) tests for Portuguese adults. DESIGN Cross-sectional study. Descriptive statistics were explored to compute reference values and reference equations were established with a forward stepwise multiple regression. SETTING Community. PARTICIPANTS 546 adult volunteers without disabilities [age range 18 to 95 years; 58% female] were recruited. MAIN OUTCOME MEASURES Data on age, sex, height, weight, body mass index (BMI), smoking status and physical activity were collected using a structured questionnaire developed specifically for this study. PROCEDURE Participants performed three repetitions of the 1MSTS and 5TSTS and the best repetition was used for analysis. RESULTS Normative values were provided by sex for each age decade. Reference equations were: 1MSTS= 61.53 - (0.34 x age) - (3.57 x sex) - (0.33 x BMI), r2 = 26%; and 5TSTS= 3.89 + (0.10 x age) - (0.96 x physical activity), r2 = 27%. CONCLUSIONS The proposed reference values and equations will help to interpret the results of functional capacity obtained from healthy or diseased adult populations. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- R Vilarinho
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal; FP-I3ID, Escola Superior de Saúde - Fernando Pessoa, 4200-256 Porto, Portugal.
| | - A Mesquita Montes
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal; Department of Physiotherapy, Santa Maria Health School, 4049-024 Porto, Portugal
| | - A Noites
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - F Silva
- FP-I3ID, Escola Superior de Saúde - Fernando Pessoa, 4200-256 Porto, Portugal
| | - C Melo
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
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Betz MW, De Brandt J, Aussieker T, Monsegue AP, Houtvast DCJ, Gehlert S, Verdijk LB, van Loon LJC, Gosker HR, Langen RJC, Derave W, Burtin C, Spruit MA, Snijders T. Muscle fibre satellite cells are located at a greater distance from capillaries in patients with COPD compared with healthy controls. ERJ Open Res 2024; 10:00203-2024. [PMID: 39351378 PMCID: PMC11440426 DOI: 10.1183/23120541.00203-2024] [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: 03/04/2024] [Accepted: 05/13/2024] [Indexed: 10/04/2024] Open
Abstract
Background COPD is a disease characterised by skeletal muscle dysfunction. A spatial relationship exists between satellite cells and muscle fibre capillaries, which has been suggested to be of major importance for satellite cell function. In the present study we compared the spatial relationship between satellite cells and capillaries in patients with COPD and age-matched healthy older adults. Methods Muscle biopsies were obtained from the vastus lateralis of n=18 patients with COPD (8 female, 10 male; age 66±5 years, mild-to-severe airflow obstruction) and n=18 age-, sex- and body mass index-matched healthy control adults (8 female, 10 male; age 68±5 years). Immunohistochemistry was used to assess type I/II muscle fibre size, distribution, myonuclear content, satellite cell number and fibre capillarisation. In addition, type I/II muscle fibre satellite cell distance to its nearest capillary was assessed. Results The percentage of type II muscle fibres was significantly greater in patients with COPD (62±10%) compared with controls (50±12%, p<0.05). Muscle fibre capillarisation was significantly lower in patients with COPD compared with controls (p<0.05). While satellite cell content was not different between groups, type I and type II satellite cell distance to its nearest capillary was significantly greater in patients with COPD (type I: 21.3±4.8 µm; type II: 26.7±9.3 µm) compared with controls (type I: 16.1±3.5 µm; type II: 22.7±5.8 µm; p<0.05). Conclusion Satellite cells are located at a greater distance from their nearest capillary in patients with COPD compared with age-matched controls. This increased distance could play a role in impaired satellite cell function in patients with COPD.
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Affiliation(s)
- Milan W Betz
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
| | - Jana De Brandt
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Thorben Aussieker
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
| | - Alejandra P Monsegue
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
| | - Dion C J Houtvast
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
| | - Sebastian Gehlert
- Department for Biosciences of Sports, Institute for Sport Science, University of Hildesheim, Hildesheim, Germany
| | - Lex B Verdijk
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
| | - Luc J C van Loon
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
| | - Harry R Gosker
- NUTRIM, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Ramon J C Langen
- NUTRIM, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Wim Derave
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Chris Burtin
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Martijn A Spruit
- NUTRIM, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, The Netherlands
- Department of Research and Education, CIRO+, Horn, The Netherlands
| | - Tim Snijders
- NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Human Biology, Maastricht, The Netherlands
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Ruelland C, Beaumont M. [Effects of gender on pulmonary rehabilitation outcomes in patients with COPD]. Rev Mal Respir 2024; 41:463-471. [PMID: 38945799 DOI: 10.1016/j.rmr.2024.06.007] [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] [Received: 09/21/2023] [Accepted: 06/07/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION COPD has become more prevalent among women, revealing a specific feminine phenotype. Women experience greater dyspnea and a more impaired quality of life. The main objective of this study was to assess the effect of gender on dyspnea during a pulmonary rehabilitation program (PRP). METHODS Retrospective study including COPD patients having participated in PRPs. The following data were analyzed according to gender before and after a PRP: dyspnea, quality of life, anxiety and depression, exercise capacity, muscle function (quadriceps and inspiratory muscles). RESULTS More than 500 patients (252 men and 252 women) were included. We did not find a significant effect of gender on the evolution of dyspnea, anxiety or depressive disorders, exercise capacity, inspiratory muscle strength, or overall quality of life score. That said, we found a possible effect on the sub-scores of the quality of life questionnaire, and regarding quadriceps strength. All criteria improved during the program in both groups. CONCLUSIONS During a PRP, gender does not impact the evolution of dyspnea. While women may nonetheless benefit to a greater extent in terms of quality of life sub-scores (impact, activities, symptoms) and quadriceps strength, these results still require confirmation.
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Affiliation(s)
- C Ruelland
- Service de réadaptation respiratoire, Médipôle Lyon-Villeurbanne, Villeurbanne, France
| | - M Beaumont
- Service de réadaptation respiratoire, CH des Pays de Morlaix, 15, Kersaint Gilly, 29600 Morlaix, France; Inserm, université de Brest, CHRU de Brest, UMR 1304, GETBO, Brest, France.
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Sebio-Garcia R, Montané-Muntané M, González-Colom R, Tena B, Dana F, Sisó M, Peláez A, Campero B, Diéguez-Porto I, Capitán D, Borda D, Martínez-Pallí G. Association between the 6MWT and other measurements of physical functioning in patients with cancer awaiting major surgery. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108510. [PMID: 38945057 DOI: 10.1016/j.ejso.2024.108510] [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] [Received: 04/23/2024] [Revised: 05/26/2024] [Accepted: 06/23/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The Six Minute Walk Test (6MWT) is a widely used measure of functional capacity in (p)rehabilitation of cancer patients, but it is time-consuming and requires specific space conditions. In this study we explore the association between the 6MWT with other measurements of physical functioning and their predictive value in classifying patients according to their estimated functional capacity. DESIGN This prospective study included cancer patients referred to a prehabilitation programme prior to major surgery. For each patient, data on different measurements of physical functioning including the Duke Activity Status Index (DASI), the handgrip strength, the 30" Sit-to-Stand Test and self-reported physical activity levels were collected. Bivariate associations were performed to determine the association between the 6MWT and other variables. Multivariate analyses were performed to identify potential predictive factors of 6MWT in this population. A subsequent algorithm was developed to classify patients based on their functional capacity (good performance - 6MWT>400 m or poor performance 6MWT<400 m) RESULTS: Between mid-2018 to mid 2022, 692 patients were assessed of whom the 6MWT was performed in 524 (75.7 %) (mean age 72.5 ± 11.8 years; 57.1 % men). Moderate-to-strong correlations were found between 6MWT and 30" Sit-To-Stand Test (r = 0.54, p < 0.001), DASI (r = 0.68; p < 0.001) and handgrip strength (r = 0.5; p < 0.001). Multivariate analyses confirmed that a combination of six variables were able to classify 80 % of patients in good (>400 m) or poor (<400 m) performance in the 6MWT. CONCLUSION The 6MWT was moderately associated with several variables of physical functioning, a combination of which can be used to predict performance in the 6MWT.
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Affiliation(s)
- Raquel Sebio-Garcia
- Department of Physical Medicine and Rehabilitation, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques Agustí Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain.
| | - Mar Montané-Muntané
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Rubèn González-Colom
- Institut D'Investigacions Biomèdiques Agustí Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain.
| | - Beatriz Tena
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Fernando Dana
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Marina Sisó
- Department of Endocrinology and Metabolic Diseases, Hospital Clinic de Barcelona, Barcelona, Spain.
| | - Amaia Peláez
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Betina Campero
- Department of Endocrinology and Metabolic Diseases, Hospital Clinic de Barcelona, Barcelona, Spain.
| | - Iago Diéguez-Porto
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - David Capitán
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Daniel Borda
- Department of Physical Medicine and Rehabilitation, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Graciela Martínez-Pallí
- Department of Anaesthesia, Reanimation and Pain Management, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques Agustí Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid, Spain.
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Pecha A, White B, Yan H. Exploring Functional Improvements by Sex in Six-Minute Walk Test, Exertional Angina, and Dyspnea After Enhanced External Counterpulsation Therapy. J Cardiopulm Rehabil Prev 2024; 44:333-338. [PMID: 39185903 DOI: 10.1097/hcr.0000000000000893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
PURPOSE The objective of this study was to explore functional improvements by sex for patients with refractory angina pectoris using a 6-min walk test (6MWT) after enhanced external counterpulsation (EECP) therapy. METHODS All patients who completed EECP from 2015 to 2023 were identified for analysis retrospectively, utilizing the electronic medical record. Patients completed 35 1-hr EECP sessions 5 d/wk over 7 wk. All baseline and post-EECP intervention 6MWT, exertional angina, and dyspnea measurements were assessed on the first and last sessions, respectively. Paired and unpaired t tests and linear and stepwise multivariable regression analyses were performed. RESULTS The cohort consisted of 116 patients (24 female) with a mean age of 69 ± 13 yr. After EECP, there was a mean improvement of 128 m (72%) in distance walked during the 6MWT ( P < .001) with 126 ± 91 m improvement in males and 134 ± 73 m in females. The improvement in angina and dyspnea scores was 3.5 ± 2.1 and 4.2 ± 2.4, respectively. There were no differences between the sexes for improvements in 6MWT distance, angina, or dyspnea. Univariate associations for change in 6MWT distance included body mass index (BMI; adjusted R2 = .05) and being a nonsmoker (adjusted R2 = .03). The only independent predictor for increasing distance during 6MWT was BMI (adjusted R2 = .1; P = .001). CONCLUSION Patients who have refractory angina pectoris can improve their functional capacity while simultaneously decreasing exertional angina and dyspnea using EECP. This study highlights the equal efficacy of EECP therapy for females.
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Affiliation(s)
- Anton Pecha
- Author Affiliations: Valley Health Winchester Medical Center, Winchester, VA (Mr Pecha and Mr White); and University of Massachusetts Boston, Boston, MA (Mr Pecha and Dr Yan)
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Eglin M, Schmid JP, Ronel J, Khatami R, Leiggener C, Koenig HG, Hefti R. Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in Switzerland. Int J Psychiatry Med 2024; 59:595-609. [PMID: 38156371 DOI: 10.1177/00912174231225801] [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] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of social support and religiosity/spirituality (R/S) on the recovery from an acute cardiac event or cardiac surgery during cardiac rehabilitation (CR). METHODS In this prospective study, a convenience sample of 159 patients participating in a CR program were enrolled. Religiosity/spirituality, social support, anxiety, depression, health related quality of life (QoL), and exercise capacity (6-min walk test, cycle ergometer test) were assessed. RESULTS Social support was significantly associated with less anxiety (p < .01), less depression (p < .01), and better QoL (p < .05) on admission. After adjustment for age, gender, education level, and morbidity, social support remained significantly associated with less depression (p < .001). Religiosity/spirituality was significantly associated with less depression (p < .05), better QoL (p < .05), and better exercise capacity (p < .05) at admission. After adjustment for covariates, however, significance was lost. There were no significant impact of either social support or R/S on the course of CR measured by change in QoL or exercise capacity. CONCLUSION Social support may be a protective factor against depression in the recovery from cardiac events or surgery. Neither social support nor R/S had a significant impact on the course of the 3-week CR program.
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Affiliation(s)
- Micha Eglin
- University of Basel, Faculty of Medicine, Basel, Switzerland
| | | | - Joram Ronel
- Department of Psychosomatic Medicine and Psychotherapy, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Ramin Khatami
- Centre of Sleep Medicine and Sleep Research, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Christoph Leiggener
- University of Basel, Faculty of Medicine, Basel, Switzerland
- Department of Oral- and Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Harold G Koenig
- Departments of Medicine and Psychiatry, Duke University Health System, Durham, NC, USA
- Department of Medicine, Division of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - René Hefti
- University of Basel, Faculty of Medicine, Basel, Switzerland
- Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
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Surapichpong S, Jisarojito S, Surapichpong C. A comparison of new cardiovascular endurance test using the 2-minute marching test vs. 6-minute walk test in healthy volunteers: A crossover randomized controlled trial. PLoS One 2024; 19:e0307650. [PMID: 39197029 PMCID: PMC11356390 DOI: 10.1371/journal.pone.0307650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 07/09/2024] [Indexed: 08/30/2024] Open
Abstract
TRIAL DESIGN This was a 2×2 randomized crossover control trial. OBJECTIVE To compare the cardiovascular endurance of healthy volunteers using a 2-minute marching test (2MMT) and a 6-minute walk test (6MWT). METHODS This study included 254 participants of both sexes, aged 20-50 years, with a height and body mass index (BMI) of ≥150 cm and ≤25 kg/m2, respectively. Participants were hospital staff who could perform activities independently and had normal annual chest radiographs and electrocardiograms. A group-randomized design was used to assign participants to Sequence 1 (AB) or 2 (BA). The tests were conducted over 2 consecutive days, with a 1-day washout period. On day 1, the participants randomly underwent either a 6MWT or 2MMT in a single-anonymized setup, and on day 2, the tests were performed in reverse order. We analyzed maximal oxygen consumption (VO2max) as the primary outcome and heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation, dyspnea, and leg fatigue as secondary outcomes. RESULTS Data were collected from 127 participants, categorized into two groups for different testing sequences. The first (AB) and second groups had 63 and 64 participants, respectively. The estimated VO2max was equivalent between both groups. The 2MMT and 6MWT estimated VO2max with a mean of 41.00 ± 3.95 mL/kg/min and 40.65 ± 3.98 mL/kg/min, respectively. The mean difference was -0.35 mL/kg/min (95% confidence interval: -1.09 to 0.38; p <0.001), and no treatment and carryover effect were observed. No significant changes were observed in HR, RR, and systolic BP (p = 0.295, p = 0.361 and p = 0.389, respectively). However, significant changes were found in the ratings of perceived exertion (p <0.001) and leg fatigue scale (p <0.001). CONCLUSION The 2MMT is practical, simple, and equivalent to the 6MWT in estimating VO2max. TRIAL REGISTRATION TCTR20220528004 https://www.thaiclinicaltrials.org.
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Affiliation(s)
- Suchai Surapichpong
- Rehabilitation Center, Bangkok Hospital Headquarters, Bangkok Dusit Medical Services, Bangkok, Thailand
| | - Sucheela Jisarojito
- Rehabilitation Center, Bangkok Hospital Headquarters, Bangkok Dusit Medical Services, Bangkok, Thailand
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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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Rimaud D, Testa R, Millet GY, Calmels P. Effects of carbon versus plastic ankle foot orthoses on gait outcomes and energy cost in patients with chronic stroke. J Rehabil Med 2024; 56:jrm35213. [PMID: 39175453 PMCID: PMC11358842 DOI: 10.2340/jrm.v56.35213] [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] [Received: 12/19/2023] [Accepted: 07/15/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE To compare the walking performances of hemiplegic subjects with chronic stroke under 3 conditions: with a new standard carbon fibre ankle foot orthosis (C-AFO), with a personal custom-made plastic AFO (P-AFO), and without any orthosis (No-AFO). DESIGN Randomized, controlled crossover design. PATIENTS Fifteen chronic patients with stroke (3 women and 12 men, 59 [10] years, 13 [15] years since injury). METHODS Patients performed 3 randomized sessions (with C-AFO, P-AFO, no-AFO), consisting of a 6-min walk test (6MWT) with VO2 measurement and a clinical gait analysis. Energy cost (Cw), walking speed, spatio-temporal, kinetic, and kinematic variables were measured. RESULTS No significant differences were found between the C-AFO and P-AFO conditions. Distance and walking speed in the 6MWT increased by 12% and 10% (p < 0.001) and stride width decreased by -8.7% and -13% (p < 0.0001) with P-AFO and C-AFO compared with the No-AFO condition. Cw decreased by 15% (p < 0.002), stride length increased by 10% (p < 0.01), step length on affected leg increased by 8% (p < 0.01), step length on contralateral leg by 13% (p < 0.01), and swing time on the contralateral leg increased by 6% (p < 0.01) with both AFO compared with the No-AFO condition. CONCLUSION The use of an off-the-shelf composite AFO (after a short habituation period) in patients with chronic stroke immediately improved energy cost and gait outcomes to the same extent as their usual custom-made AFO.
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Affiliation(s)
- Diana Rimaud
- Université Jean Monnet Saint-Etienne, CHU Saint-Etienne, Physical Medicine and Rehabilitation Department, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France.
| | - Rodolphe Testa
- Université Jean Monnet Saint-Etienne, CHU Saint-Etienne, Department of Orthopaedic Surgery, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France
| | - Guillaume Y Millet
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France; Institut Universitaire de France (IUF)
| | - Paul Calmels
- Université Jean Monnet Saint-Etienne, CHU Saint-Etienne, Physical Medicine and Rehabilitation Department, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France
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Thu HNT, Khac BL, Poncin W. Reliability of the 1-minute sit-to-stand test in chronic obstructive pulmonary disease. Ann Phys Rehabil Med 2024; 67:101866. [PMID: 39173551 DOI: 10.1016/j.rehab.2024.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/19/2024] [Accepted: 05/13/2024] [Indexed: 08/24/2024]
Affiliation(s)
- Hang Nguyen Thi Thu
- Department of Rehabilitation, Hai Duong Medical Technical University, 1 Vu Huu, Thanh Binh Ward, Hai Duong City, Hai Duong Province, Vietnam
| | - Bao Le Khac
- Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam; Respiratory Medicine Department, Gia Dinh People's Hospital, 1 No Trang Long, Ward 7, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - William Poncin
- Institut de Recherche Expérimentale et Clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
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Harvey-Dunstan TC, Baldwin MM, Tal-Singer R, Allinder M, Polkey MI, Hamilton A, Richardson M, Edwards SA, Steiner MC, Morgan MD, Singh SJ. The Responsiveness of Exercise Tests in COPD: A Randomized Controlled Trial. Chest 2024:S0012-3692(24)04900-6. [PMID: 39173827 DOI: 10.1016/j.chest.2024.05.051] [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: 12/20/2023] [Revised: 05/01/2024] [Accepted: 05/17/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND COPD is characterized by reduced exercise tolerance, and improving physical performance is an important therapeutic goal. A variety of exercise tests commonly are used to assess exercise tolerance, including laboratory and field-based tests. The responsiveness of these tests to common COPD interventions is yet to be compared, but the results may inform test selection in clinical and research settings. RESEARCH QUESTION What exercise test possesses the greatest sensitivity to change from before to after intervention in patients with COPD? STUDY DESIGN AND METHODS One hundred fifty-four patients with symptomatic COPD were recruited and randomized (2:1:1) to 6 weeks of long-acting muscarinic antagonist (LAMA), pulmonary rehabilitation (PR), or usual care. Before and after intervention, participants performed a ramp-incremental cycle exercise test (ICET) and constant work rate cycle test (CWRCT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT), 6-min walk test (6MWT), and 4-m gait speed test. RESULTS One hundred three participants (mean ± SD age, 67 ± 8 years; 75 male participants [73%]; FEV1, 50.6 ± 16.8% predicted) completed the study. Significant improvements in the ICET, CWRCT, ISWT, ESWT, and 6MWT results were observed after PR (P < .05), with the greatest improvements seen in the constant work rate protocols (percentages change: CWRCT, 42%; ESWT, 41%). INTERPRETATION The ESWT and CWRCT seemed to be the most responsive exercise test protocols to LAMA and PR therapy. The magnitude of change was much greater after a program of rehabilitation compared with bronchodilator therapy. TRIAL REGISTRY ISRCTN; No. 64759523.
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Affiliation(s)
- Theresa C Harvey-Dunstan
- Physiotherapy and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, England; Institute for Lung Health, Leicester NIHR Biomedical Research Centre-Respiratory, Glenfield Hospital, Leicester, England.
| | - M M Baldwin
- Institute for Lung Health, Leicester NIHR Biomedical Research Centre-Respiratory, Glenfield Hospital, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England
| | | | | | - M I Polkey
- NIHR Respiratory Biomedical Research Unit, Royal Brompton Hospital and Imperial College, London, England
| | - A Hamilton
- Boehringer Ingelheim (Canada) Ltd., Burlington, Canada
| | - M Richardson
- Physiotherapy and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, England
| | - S A Edwards
- Physiotherapy and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, England
| | - M C Steiner
- Physiotherapy and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England
| | - M D Morgan
- Institute for Lung Health, Leicester NIHR Biomedical Research Centre-Respiratory, Glenfield Hospital, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England
| | - S J Singh
- Institute for Lung Health, Leicester NIHR Biomedical Research Centre-Respiratory, Glenfield Hospital, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England
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Guimarães Paiva L, de Oliveira TMD, de Souza NB, Alberto KC, Almeida DP, Oliveira CC, José A, Malaguti C. Exploring the impact of the environment on physical activity in patients with chronic obstructive pulmonary disease (EPCOT)-A comparative analysis between suggested and free walking: Protocol study. PLoS One 2024; 19:e0306045. [PMID: 39137186 PMCID: PMC11321554 DOI: 10.1371/journal.pone.0306045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Individuals with chronic obstructive pulmonary disease (COPD) exhibit reduced levels of physical activity, which are associated with poorer outcomes. The number of clinical trials aiming to promote behavioral changes to increase physical activity in this population has grown; therefore, these trials have yet to produce satisfactory results. An ecological model encompassing individual, social, environmental, and political factors represent a potentially more effective approach to promoting physical activity. While favorable urban environments can positively impact physical activity, specifically tailored environmental interventions for individuals with COPD could enhance their engagement in physical activity. Therefore, the aim of this randomized controlled trial (RCT) study was to analyze the effects of walking in a suggested environment and free walking on physical activity levels in individuals with COPD. METHODS The environment on physical activity for chronic obstructive disease (EPCOT) is a randomized controlled clinical trial protocol approved by our institution's Ethics Committee and registered with The Brazilian Registry of Clinical Trials (ReBEC) (https://ensaiosclinicos.gov.br, number RBR-4tfwdhp). This protocol will involve 38 volunteers diagnosed with COPD recruited from the pulmonary physiotherapy and rehabilitation service. The volunteers were randomly divided into two walking groups: an experimental group (ERG) with guidance for walking in a suggested environment and an active control group (ACG) instructed to choose their own routes. The intervention consisted of eight consecutive weeks, with progressive walks carried out 3 to 5 times weekly. The primary outcome will be assessing participants' physical activity levels. Secondary outcomes will include exercise capacity, quality of life, dyspnea levels, motivation, anxiety, depression, and perceptions of the environment. All assessments will occur before and after the intervention period, aiming to fill a literature gap by investigating the impact of urban environments on COPD-related physical activity. The results may shed light on the importance of environmental factors in promoting physical activity among individuals with COPD, helping to develop more effective interventions.
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Affiliation(s)
- Larissa Guimarães Paiva
- Graduate Program of Rehabilitation Sciences and Physical and Functional Performance, Federal University of Juiz de Fora (UFJF) - Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Túlio Medina Dutra de Oliveira
- Graduate Program in Health, Federal University of Juiz de Fora (UFJF) - Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Nara Batista de Souza
- Graduate Program of Rehabilitation Sciences and Physical and Functional Performance, Federal University of Juiz de Fora (UFJF) - Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Klaus Chaves Alberto
- Graduate Program in Built Environment, Federal University of Juiz de Fora (UFJF) - Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Daniela Pereira Almeida
- Graduate Program in Architecture and Urbanism, Federal University of Viçosa (UFV) - Viçosa, Viçosa, Minas Gerais, Brazil
| | - Cristino Carneiro Oliveira
- Graduate Program of Rehabilitation Sciences and Physical and Functional Performance, Federal University of Juiz de Fora (UFJF) - Governador Valadares, Governador Valadares, Minas Gerais, Brazil
- Graduation Program on Rehabilitation Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Anderson José
- Graduate Program of Rehabilitation Sciences and Physical and Functional Performance, Federal University of Juiz de Fora (UFJF) - Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Carla Malaguti
- Graduate Program of Rehabilitation Sciences and Physical and Functional Performance, Graduate Program in Health, Federal University of Juiz de Fora (UFJF) - Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Farver-Vestergaard I, Buksted EH, Sørensen D, Jonstrup S, Hansen H, Christiansen CF, Løkke A. Changes in COPD-related anxiety symptoms during pulmonary rehabilitation: a prospective quantitative and qualitative study. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1428893. [PMID: 39169921 PMCID: PMC11335722 DOI: 10.3389/fresc.2024.1428893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/01/2024] [Indexed: 08/23/2024]
Abstract
Background Fear-avoidance in COPD can have detrimental effects on pulmonary rehabilitation (PR) outcomes and is therefore important to address. This prospective study examined changes in and management of COPD-related anxiety symptoms over the course of a PR program. Methods Patients with COPD referred to 9-weeks of PR in the municipality of Vejle, Denmark from January to December 2022 completed a six-minute walk test (6MWT) and the following questionnaires, both before and after PR: COPD Anxiety Questionnaire 20-item version (CAF-R), measuring COPD-related anxiety; COPD Assessment Test (CAT), measuring COPD-related disability; 12-Item Short-Form Health Survey (SF-12), measuring health-related quality of life (HR-QoL); sociodemographic and disease-related information. After PR, a subsample of the patients took part in semi-structured interviews exploring their understanding of how they managed COPD-related anxiety during PR. Pre- and post-assessment of COPD-related anxiety and other PR outcomes were analysed with t-tests and correlation analyses. Qualitative interviews were analysed using a thematic analysis approach. Results A total of 72 patients with COPD (mean ± SD age 71 ± 8, 53% female) were included in the study, and 13 took part in qualitative interviews. A significant decrease in COPD-related anxiety was observed from before to after PR, corresponding to a small effect size (Cohen's d = 0.32; p = 0.018). Reductions in COPD-related anxiety were not associated with improvements in COPD-related disability, HR-QOL, or functional exercise capacity. The qualitative findings identified four anxiety management strategies, i.e., "planning", "problem-solving", "accepting", and "confronting", which were influenced by interactions with healthcare professionals and co-patients as well as patients' own perception. Conclusions COPD-related anxiety symptoms was reduced after PR, potentially through the use of various management strategies. The strategies appeared to be influenced by interactional factors during the PR program.
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Affiliation(s)
- Ingeborg Farver-Vestergaard
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Eva Holmegaard Buksted
- VIA Research Centre for Health and Welfare Technology, Program for Rehabilitation, VIA University College, Aarhus, Denmark
| | - Dorthe Sørensen
- VIA Research Centre for Health and Welfare Technology, Program for Rehabilitation, VIA University College, Aarhus, Denmark
| | - Sune Jonstrup
- Department of Health, Vejle Municipality, Vejle, Denmark
| | - Henrik Hansen
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, Hvidovre, Denmark
- Institute of Rehabilitation Sciences, University of Antwerp, Antwerp, Belgium
| | - Camilla Fischer Christiansen
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Manifield J, Alexiou C, Megaritis D, Baker K, Adams N, Barry G, Vogiatzis I. Effects of inspiratory muscle training on thoracoabdominal volume regulation in older adults: A randomised controlled trial. Respir Physiol Neurobiol 2024; 326:104278. [PMID: 38735425 DOI: 10.1016/j.resp.2024.104278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/22/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES We investigated the effect of inspiratory muscle training (IMT) on inspiratory muscle strength, functional capacity and respiratory muscle kinematics during exercise in healthy older adults. METHODS 24 adults were randomised into an IMT or SHAM-IMT group. Both groups performed 30 breaths, twice daily, for 8 weeks, at intensities of ∼50 % maximal inspiratory pressure (PImax; IMT) or <15 % PImax (SHAM-IMT). Measurements of PImax, breathing discomfort during a bout of IMT, six-minute walk distance, physical activity levels, and balance were assessed pre- and post-intervention. Respiratory muscle kinematics were assessed via optoelectronic plethysmography (OEP) during constant work rate cycling. RESULTS PImax was significantly improved (by 20.0±11.9 cmH2O; p=0.001) in the IMT group only. Breathing discomfort ratings during IMT significantly decreased (from 3.5±0.9-1.7±0.8). Daily sedentary time was decreased (by 28.0±39.8 min; p=0.042), and reactive balance significantly improved (by 1.2±0.8; p<0.001) in the IMT group only. OEP measures showed a significantly greater contribution of the pulmonary and abdominal rib cage compartments to total tidal volume expansion post-IMT. CONCLUSIONS IMT significantly improves inspiratory muscle strength and breathing discomfort in this population. IMT induces greater rib cage expansion and diaphragm descent during exercise, thereby suggesting a less restrictive effect on thoracic expansion and increased diaphragmatic power generation.
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Affiliation(s)
- James Manifield
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK.
| | - Charikleia Alexiou
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Nicola Adams
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
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Ubré M, Montané-Muntané M, Diéguez I, Martínez-Pallí G. 10 years of prehabilitation: From theory to clinical practice. Cir Esp 2024; 102:451-458. [PMID: 38718979 DOI: 10.1016/j.cireng.2024.04.010] [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] [Received: 01/10/2024] [Accepted: 04/04/2024] [Indexed: 08/06/2024]
Abstract
In recent years, prehabilitation has generated high expectations as an innovative preoperative strategy to enhance clinical outcomes following surgery. Several studies have demonstrated that multimodal programs are effective in improving patients' health status and cardiopulmonary reserve, allowing them to undergo surgery in better conditions and, consequently, reducing the incidence of postoperative complications. Most publications describe proof-of-concept studies, and literature about their implementation is more limited. The implementation of these programs requires new resources and significant organizational effort. In this paper, we share our experience implementing a multimodal prehabilitation program as a mainstream service at a tertiary hospital. Although there are still many unknowns regarding the optimal selection of patients, as well as the duration and components of the program, this article describes our journey in this field, aiming to provide insight for teams interested in developing a similar project.
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Affiliation(s)
- Marta Ubré
- Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Mar Montané-Muntané
- Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Iago Diéguez
- Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Graciela Martínez-Pallí
- Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain
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Oliveira MR, Hoffman M, Jones AW, Holland AE, Borghi-Silva A. Effect of Pulmonary Rehabilitation on Exercise Capacity, Dyspnea, Fatigue, and Peripheral Muscle Strength in Patients With Post-COVID-19 Syndrome: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:1559-1570. [PMID: 38311096 DOI: 10.1016/j.apmr.2024.01.007] [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] [Received: 09/18/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE To establish the effects of pulmonary rehabilitation (PR) in patients with persistent symptoms after COVID-19 infection. In addition, to compare the modalities of PR services (face-to-face and telerehabilitation) and the duration of PR in weeks (4-8 weeks and >8 weeks). DATA SOURCES PubMed/MEDLINE, Embase (Elsevier), Central/Cochrane Library, SciELO Citation Index (Web of Science), and CINAHL. STUDY SELECTION Studies determining the effects of PR in patients with post-COVID-19 syndrome were included and grouped according to PR delivery modality. DATA EXTRACTION Data extraction and quality assessment were independently performed by 2 reviewers. The methodological quality was assessed using the Cochrane Risk of Bias Tool 1 (RoB-1). DATA SYNTHESIS The literature search retrieved 1406 articles, of which 7 studies explored the effects of PR on patients with post-COVID-19 syndrome, with 188 patients randomized to PR. The mean age of participants was 50 years and 49% were women. Meta-analysis showed an increase in exercise capacity with PR compared with control (6-minute walking test: mean difference: 60.56 m, 95% confidence interval: 40.75-80.36), a reduction in fatigue (Fatigue Severity Scale: -0.90, -1.49 to -0.31) but no change in dyspnea (-0.57, -1.32 to 0.17) and muscle strength (3.03, -1.89 to 7.96). There were no differences between telerehabilitation and face-to-face PR regarding effects on peripheral muscle strength (P=.42), dyspnea (P=.83), and fatigue (P=.34). There were no differences between programs 4-8 weeks and >8 weeks regarding exercise capacity (P=.83), peripheral muscle strength (P=.42), and dyspnea (P=.76). CONCLUSIONS PR improves exercise capacity and reduces fatigue in patients with post-COVID-19 syndrome. Duration of PR (4-8 weeks vs > 8 weeks) or PR modality (telerehabilitation vs face-to-face) did not affect outcomes but data were limited and based on subgroup analysis. Further evidence is required to determine the optimal delivery mode and duration of PR for post-COVID-19 syndrome.
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Affiliation(s)
- Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, Brazil; Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil.
| | - Mariana Hoffman
- Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil
| | - Arwel W Jones
- Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil
| | - Anne E Holland
- Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil; Physiotherapy Department, Alfred Health, Melbourne, Australia
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, Brazil; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL
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Butson G, Edbrooke L, Ismail H, Denehy L. Exercise capacity prior to major cancer surgery: A cross-sectional observational study of the validity of the 6-minute walk and 30-second sit-to-stand tests. Asia Pac J Clin Oncol 2024; 20:497-506. [PMID: 38685578 DOI: 10.1111/ajco.14069] [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] [Received: 07/24/2023] [Revised: 02/26/2024] [Accepted: 04/06/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Cardiopulmonary exercise testing (CPET) is the gold standard for measuring exercise capacity, however, it is resource intensive and has limited availability. This study aimed to determine: 1) the association between the 6-min walk test (6MWT) and the 30-s sit-to-stand test (30STS) with CPET peak oxygen uptake (VO2peak) and anaerobic threshold (AT) and 2) 6MWT and 30STS cut points associated with a higher risk of postoperative complications. METHODS A cross-sectional study, retrospectively analyzing data collected from a tertiary cancer center over a 23-month period. Measures included CPET VO2peak and AT, 6MWT and 30STS test. Correlations were used to characterize relationships between variables. Receiver operating characteristic curve analyses determined 6MWT and 30STS cut points that aligned with CPET variable cut points. RESULTS Note that, 156 participants were included. The 6MWT and 30STS displayed moderate correlations with VO2peak, rho = 0.65, p = 0.01 and rho = 0.52, p < 0.005 respectively. Fair correlations were observed between AT and 6MWT (rho = 0.36, p = 0.01) and 30STS (rho = 0.41, p < 0.005). The optimal cut points to identify VO2peak < 15 mL/kg/min were 493.5 m on the 6MWT and 12.5 stands on the 30STS test and for AT < 11 mL/kg/min were 506.5 m on the 6MWT and 12.5 stands on the 30STS test. CONCLUSION Both the 6MWT and 30STS test could be used as alternative tools for measuring exercise capacity preoperatively in the cancer setting where CPET is not available. A range of 6MWT and 30STS cut points, according to sensitivity and specificity levels, may be used to evaluate risk of postoperative outcomes.
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Affiliation(s)
- Grace Butson
- Department of Physiotherapy, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Lara Edbrooke
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
| | - Hilmy Ismail
- Department of Anesthesia, Perioperative and Pain Medicine, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Linda Denehy
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
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Yu R, Lai D, Leung G, Tong C, Woo J. Using cardiorespiratory fitness to operationalize vitality: a path analysis on the hierarchical structure of intrinsic capacity. J Nutr Health Aging 2024; 28:100300. [PMID: 38908298 DOI: 10.1016/j.jnha.2024.100300] [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] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/12/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND There is a lack of consensus about the operationalization of vitality, which is one of the intrinsic capacity (IC) domains. In particular, no study has investigated whether cardiorespiratory fitness (CRF) can be considered a vitality indicator. OBJECTIVE To examine whether vitality is the upstream domain of IC, and establish the validity of CRF as a vitality indicator, using maximal oxygen consumption (VO2 max) as a representative. METHODS 561 older adults from a longitudinal cohort study were included. Variables under consideration were VO2 max, other IC domains, instrumental activities of daily living (IADL), and handgrip strength, which was considered an already validated indicator of vitality. Using handgrip strength as the reference point, path analyses were performed to examine whether VO2 max followed a similar hierarchical structure in predicting change in IADL difficulty through other IC domains. RESULTS The mean age of the participants was 75.5 years. The path model in which vitality was measured by VO2 max demonstrated adequate fit, which was similar to the model in which vitality was measured by handgrip strength. Regarding the path coefficients, the model using VO2 max demonstrated significant total and indirect effects. Notably, the indirect effect was due to the locomotor domain (standardized coefficient = -0.148, p < .001), but not the cognitive or psychological domain. CONCLUSION Vitality is the upstream domain of IC. VO2 max can be considered an indicator to operationalize the vitality concept.
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Affiliation(s)
- Ruby Yu
- The Chinese University of Hong Kong, Hong Kong.
| | - Derek Lai
- The Chinese University of Hong Kong, Hong Kong
| | - Grace Leung
- The Chinese University of Hong Kong, Hong Kong
| | | | - Jean Woo
- The Chinese University of Hong Kong, Hong Kong
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Veley A, Degen M, Rimmer L, Collins L, Dorocicz I, Smith J, Barclay R, Scodras S, Alsbury-Nealy K, Salbach NM. Do measures of physical capacity and walking self-efficacy relate to frailty in older adults with difficulty walking outdoors? A secondary data analysis. Disabil Rehabil 2024; 46:3905-3912. [PMID: 37787058 DOI: 10.1080/09638288.2023.2258336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Measures of physical capacity and self-efficacy may help rehabilitation professionals better understand and detect frailty in older adults. We aimed to characterize frailty, walking self-efficacy, physical capacity, and their inter-relationships in older adults with difficulty walking outdoors. MATERIALS AND METHODS A secondary analysis of baseline data from 187 older adults (age ≥ 65 years) with mobility limitations was performed. Frailty was evaluated using the cardiovascular health study frailty index. Physical capacity was measured using the 10-meter walk test (10mWT), 6-min walk test (6MWT), 30-second sit-to-stand test (30STST), mini balance evaluation systems test (mini-BESTest), and hand dynamometry. Self-efficacy was assessed using the ambulatory self-confidence questionnaire (ASCQ). We evaluated associations between scores on physical capacity and walking self-efficacy measures and frailty level using an ANOVA or the Kruskal Wallis H-test. RESULTS The percentage of participants not frail, pre-frail, and frail was 33.7%, 57.2%, and 9.1%, respectively. Median score on the 10mWT-comfortable pace, 10mWT-fast pace, 6MWT, 30STST, mini-BESTest, grip strength, and ASCQ was 1.06 m/s, 1.42 m/s, 354.0 m, 9.0 repetitions, 22 points, 23.0 kg, and 8.1 points, respectively. Scores on physical capacity and walking self-efficacy measures were associated with frailty level (p < 0.01). CONCLUSIONS Findings provide insight into the utility of rehabilitation measures to indicate frailty among older adults with mobility limitations.
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Affiliation(s)
- Andrew Veley
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Maja Degen
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Rimmer
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Collins
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Izabela Dorocicz
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Smith
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Stephanie Scodras
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kyla Alsbury-Nealy
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
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Watabe K, Goda A, Tobita K, Yokoyama S, Kikuchi H, Takeuchi K, Inami T, Soejima K, Kohno T. Determinants of physical quality of life in patients with chronic thromboembolic pulmonary hypertension after treatment: Insights from invasive exercise stress test. J Heart Lung Transplant 2024; 43:1278-1287. [PMID: 38636934 DOI: 10.1016/j.healun.2024.04.001] [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] [Received: 11/22/2023] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Impaired quality of life (QoL) is prevalent among patients with chronic thromboembolic pulmonary hypertension (CTEPH) despite improved survival due to medical advances. We clarified the physical QoL of patients with CTEPH with mildly elevated pulmonary hemodynamics and evaluated its determinants using a database of patients with CTEPH evaluated for hemodynamics during exercise. METHODS The QoL was measured in 144 patients with CTEPH (age, 66 (58-73) years; men/women, 48/96) with mildly elevated mean pulmonary artery pressure (<30 mm Hg) at rest after treatment with balloon pulmonary angioplasty and/or pulmonary endarterectomy using the Short-Form 36 (SF-36) questionnaire. The enrolled patients were divided into 2 groups: physical component summary (PCS) scores in the SF-36 over 50 as PCS-good and those under 50 as PCS-poor. RESULTS The median PCS in SF-36 score was 43.4 (IQR 32.4-49.5) points. The PCS-poor group (n = 110) was older and had lower exercise capacity and SaO2 during exercise. PCS scores were correlated with 6-minute walk distance (rs=0.40, p < 0.001), quadriceps strength (rs=0.34, p < 0.001), peak VO2 (rs=0.31, p < 0.001), SaO2 at rest (rs=0.35, p < 0.001) and peak exercise (rs=0.33, p < 0.001), home oxygen therapy usage (rs=-0.28, p = 0.001), and pulmonary vascular resistance at peak exercise (rs=-0.26, p = 0.002). CONCLUSIONS The impairment of physical QoL was common in patients with CTEPH with improved hemodynamics; exercise capacity, hypoxemia, and hemodynamic status during exercise were related to the physical QoL.
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Affiliation(s)
- Kosuke Watabe
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan
| | - Ayumi Goda
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
| | - Kazuki Tobita
- Department of Rehabilitation, Kyorin University Hospital, Tokyo, Japan
| | - Sachi Yokoyama
- Department of Rehabilitation, Kyorin University Hospital, Tokyo, Japan; Nursing Department, Yumino Heart Clinic, Tokyo, Japan
| | - Hanako Kikuchi
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan
| | - Kaori Takeuchi
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan
| | - Takumi Inami
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan
| | - Kyoko Soejima
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan
| | - Takashi Kohno
- Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan
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Oğuz MS, Bingöl Z, Pıhtılı A, Karaca Özer P, Sarıtaş Arslan M, Kılıçaslan Z, Bilge AK, Kıyan E, Okumuş G. Oxygen saturation recovery after 6-minute walk test in patients with idiopathic pulmonary fibrosis. BMC Pulm Med 2024; 24:373. [PMID: 39085811 PMCID: PMC11292883 DOI: 10.1186/s12890-024-03188-2] [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] [Received: 04/06/2024] [Accepted: 07/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The six-minute walk test (6MWT) is widely used to assess functional capacity and prognosis in patients with idiopathic pulmonary fibrosis (IPF). However, studies on oxygen saturation recovery after the 6MWT in patients with IPF are rare. In our study, we investigated the relationship between oxygen saturation recovery time and dyspnea, fatigue, quality of life, prognostic markers and pulmonary hypertension (PH). METHODS In this cross-sectional study, IPF patients diagnosed according to current guidelines and followed up in our Interstitial Lung Disease Outpatient Clinic between 2021 and 2022 were included. Demographics, data from spirometry, diffusion capacity measurement, arterial blood gas analysis, transthoracic echocardiography and the 6MWT were recorded. The oxygen saturation recovery time, distance saturation product (DSP), gender-age-physiology (GAP) index and composite physiological index (CPI) scores were calculated. Dyspnea severity was assessed by the modified Medical Research Council (mMRC) and Dyspnoea-12 (D-12) scales, fatigue severity by the Multidimensional Fatigue Inventory (MFI-20) and quality of life by the St George's Respiratory Questionnaire (SGRQ). RESULTS Fifty IPF patients (34 men, 16 women, age: 66.8 ± 7.3 years) were included in the study. The mean FVC was 77.8 ± 19.3%, the DLCO was 52.9 ± 17.1%, the 6-minute walk distance (6MWD) was 385.7 ± 90.6 m, the GAP index was 3.5 ± 1.5, and the CPI was 43.7 ± 14.1. Oxygen saturation after the 6MWT reached pretest values at an average of 135.6 ± 73.5 s. The oxygen saturation recovery time was longer in patients with higher GAP index scores (Rs = 0.870, p < 0.001), CPI scores (Rs = 0.906, p < 0.001), desaturation (Rs = 0.801, p < 0.001), FVC%/DLCO% (Rs = 0.432, p = 0.002), sPAP (Rs = 0.492, p = 0.001), TRV (Rs = 0.504, p = 0.001), mMRC (Rs = 0.913, p < 0.001), MFI-20 (Rs = 0.944, p < 0.001), D-12 scale (Rs = 0.915, p < 0.001) and SGRQ scores (Rs = 0.927, p < 0.001); lower FVC (%) (Rs=-0.627, p < 0.001), DLCO (%) (Rs=-0.892, p < 0.001), PaO2 (Rs=-0.779, p < 0.001), DSP (Rs=-0.835, p < 0.001), and 6MWD (Rs=-0.763, p < 0.001). A total of twenty patients (40%) exhibited an increased risk of PH. According to our multiple regression analysis, oxygen saturation recovery time was independently associated with the GAP index (p = 0.036), the lowest oxygen saturation occurring during the 6MWT (p = 0.011) and the SGRQ score (p < 0.001). CONCLUSIONS Our results showed that oxygen saturation recovery time is associated with dyspnea, fatigue, quality of life, increased risk of PH and prognostic markers in IPF. Therefore, we recommend continuous measurement of oxygen saturation after 6MWT until pretest values are reached.
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Affiliation(s)
- Merve Sinem Oğuz
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Züleyha Bingöl
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Aylin Pıhtılı
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Pelin Karaca Özer
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Melike Sarıtaş Arslan
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Zeki Kılıçaslan
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Esen Kıyan
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey
| | - Gülfer Okumuş
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Fatih, Istanbul, Turkey.
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Weisenburger G, Bunel V, Godet C, Salpin M, Mouren D, Menonville CTD, Goletto T, Marceau A, Borie R, Debray MP, Mal H. An underrecognized phenotype of pulmonary emphysema with marked pulmonary gas exchange but with mild or moderate airway obstruction. Respir Med Res 2024; 86:101086. [PMID: 39068737 DOI: 10.1016/j.resmer.2024.101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 07/30/2024]
Abstract
In patients with pulmonary emphysema and mild to moderate airflow limitation, one does not expect the features marked exertional dyspnea and hypoxemia as well as a profound decrease in diffusing capacity of the lung for carbon monoxide (DLCO). Here we describe this phenotype and its prognosis. From our database, we retrospectively selected cases associating emphysema, exertional breathlessness, O2 requirement at least upon exercise, forced expiratory volume in 1 sec (FEV1) ≥ 50% predicted, and DLCO ≤ 50% predicted, without associated combined pulmonary fibrosis and emphysema, right-to-left shunt, or severe pulmonary hypertension. Over a 12-year period, we identified 16 patients with emphysema and the above presentation. At the initial evaluation, the median age was 62 years (interquartile range 53.8-68.9). The median FEV1 and DLCO% predicted and mean pulmonary artery pressure were 86 (65-95)%, 38 (31-41)%, and 20 (17-25) mm Hg, respectively. On room air, the median arterial partial pressure of oxygen and partial pressure of carbon dioxide in arterial blood were 63.5 (55.8-69) mm Hg and 34.5 (31-36) mm Hg with increased median alveolar-arterial oxygen difference (46 [39-51] mm Hg). After the initial evaluation, the respiratory condition worsened in 13 of 14 (92.8%) patients with one or more re-evaluations (median follow-up 2.6 [0.9-5.8] years). In 12, lung transplantation was considered. Four patients died after 5.8, 5.7, 7.1, and 0.8 years of follow-up, respectively. We describe an underrecognized phenotype of pulmonary emphysema featuring a particular profile characterized by marked exertional dyspnea, impaired pulmonary gas exchange with low DLCO and marked oxygen desaturation at least on exercise but with mild or moderate airway obstruction.
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Affiliation(s)
- Gaelle Weisenburger
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Vincent Bunel
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Cendrine Godet
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Mathilde Salpin
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Domitille Mouren
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Charlotte Thibaut de Menonville
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Tiphaine Goletto
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Armelle Marceau
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | - Raphael Borie
- Service de pneumologie A, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France
| | | | - Hervé Mal
- Service de pneumologie B, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Inserm UMR1152, Université Paris7 Denis Diderot, 75018, Paris, France.
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Verma D, Nath RK, Pandit N, Rahatekar P, Vatsa D, Bhutani M. Prognostic utility of B-type natriuretic peptide and 6-min walk test in patients with acute decompensated heart failure. Indian Heart J 2024:S0019-4832(24)00163-9. [PMID: 39069072 DOI: 10.1016/j.ihj.2024.07.011] [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: 07/05/2023] [Revised: 01/29/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND We aimed to assess the utility of B-type natriuretic peptide (BNP) and 6-min walk test (6 MWT) together as predictors of re-hospitalization and mortality in acute decompensated heart failure (ADHF) patients. METHODS This prospective, observational, comparative study was conducted at a tertiary care center in India between October 2016 and March 2018. Patients (aged≥18 years) with ADHF and left ventricular systolic dysfunction were included in this study. The study group (N = 100 patients) consisted of patients undergoing a second BNP test along with the 6 MWT at the time of discharge and at 3-months of discharge. The control group (N = 100 patients) consisted of patients who did not undergo these tests at discharge and/or at 3-months of discharge. Study endpoints were re-hospitalization within 6-months, and in-patient and 6-month mortality. RESULTS Total 200 patients diagnosed with ADHF were enrolled. Mean age was 53.46 ± 10.12 years in the study group and 52.98 ± 9.88 years in the control group. ROC analysis of BNP level to predict re-hospitalization revealed AUC of 0.935 (p < 0.001) at admission, 0.915 (p < 0.001) at discharge, and 0.783 (p < 0.001) at 3-months. Similarly, at discharge, ROC analysis of 6 MWT to predict death gave AUC of 0.670 (p = 0.011), and at 3-months, it was 0.838 (p < 0.001). ROC analysis of BNP level to predict mortality showed AUC of 0.960 (p < 0.001) at admission, 0.947 (p < 0.001) after discharge, and 0.960 (p = 0.002) at 3-months. CONCLUSION BNP levels and 6 MWT have good prognostic utility in ADHF patients, and thus may be beneficial in making therapeutic adjustments and taking precautionary measures in these patients.
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Affiliation(s)
- Deepak Verma
- Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India.
| | - Ranjit Kumar Nath
- Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India
| | - Neeraj Pandit
- Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India
| | - Parag Rahatekar
- Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India
| | - Deepankar Vatsa
- Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India
| | - Mohit Bhutani
- Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India
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Xin H, Wei S, Zheng H, Qi Y, Xu S, Wang B, Jiang W, Deng N, Chen J. Comparison of a Supervised Home-Based Tele-Rehabilitation with Center-Based Pulmonary Rehabilitation: Protocol for a Randomized Non-Inferiority Multicenter Study in Ningxia. Int J Chron Obstruct Pulmon Dis 2024; 19:1707-1719. [PMID: 39081777 PMCID: PMC11287464 DOI: 10.2147/copd.s467945] [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] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/20/2024] [Indexed: 08/02/2024] Open
Abstract
Background Pulmonary rehabilitation (PR) is an effective intervention for people with chronic obstructive pulmonary disease (COPD). However, fewer than 5% of eligible individuals receive pulmonary rehabilitation, largely due to limited by the accessibility of rehabilitation and difficulties associated with travel and transport. Supervised home-based tele-rehabilitation (SHTR) is an alternative model to center-based pulmonary rehabilitation. We will determine whether supervised home-based tele-rehabilitation is non-inferior to center-based pulmonary rehabilitation. Methods The participants will undergo an 8-week rehabilitation program. Pulmonary rehabilitation comprises four main modules: exercise training, education, nutritional support, and psychological and behavioral interventions. We mainly focus on the module of exercise training and education. The education module includes information on exercise training, nutrition, and psychology, which are presented in an educational booklet provided to each participant. Blinded assessors will evaluate the outcomes at baseline, post-intervention, and 6 months after the intervention. The primary outcome is the change in the 6-minute walking distance. Secondary outcomes will assess changes in the patients' 1-minute sit-to-stand test, maximal inspiratory pressure (MIP), scales (CAT, mMRC, HAD), diaphragm ultrasound (TD, DE, DIF), changes in extrathoracic muscle volume and mass, completion rate of patient exercise prescriptions, occurrence of adverse events, as well as disease exacerbation and rehospitalization rates after rehabilitation and during the 6-month follow-up. Discussion In order to improve the accessibility of pulmonary rehabilitation and patient-related outcomes, it is necessary to propose an alternative model of pulmonary rehabilitation. This trial will establish whether a supervised home-based tele-rehabilitation is not inferior to traditional center-based pulmonary rehabilitation. Trial Registration Chinese Clinical Trial Registry ChiCTR2300076969. Registered on October 25, 2023.
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Affiliation(s)
- Hongxia Xin
- Department of Key Laboratory of Ningxia Stem Cell and Regenerative Medicine, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Shuoshuo Wei
- Department of Key Laboratory of Ningxia Stem Cell and Regenerative Medicine, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Department of Pulmonary and Critical Care Medicine, Affiliated Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, People’s Republic of China
| | - Hao Zheng
- Department of Pulmonary and Critical Care Medicine, Yanchi County People’s Hospital, Wuzhong, Ningxia, People’s Republic of China
| | - Yanchao Qi
- Department of Pulmonary and Critical Care Medicine, Second People’s Hospital of Shizuishan, Shizuishan, Ningxia, People’s Republic of China
| | - Shuping Xu
- Department of Pulmonary and Critical Care Medicine II, Wuzhong People’s Hospital, WuZhong, Ningxia, People’s Republic of China
| | - Bei Wang
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Wangshu Jiang
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People’s Republic of China
| | - Ning Deng
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People’s Republic of China
| | - Juan Chen
- Department of Key Laboratory of Ningxia Stem Cell and Regenerative Medicine, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
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Dupuis A, Thierry A, Perotin JM, Ancel J, Dormoy V, Dury S, Deslée G, Launois C. Obesity Impact on Dyspnea in COPD Patients. Int J Chron Obstruct Pulmon Dis 2024; 19:1695-1706. [PMID: 39070800 PMCID: PMC11277818 DOI: 10.2147/copd.s450366] [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] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/26/2024] [Indexed: 07/30/2024] Open
Abstract
Background The role of obesity on dyspnea in chronic obstructive pulmonary disease (COPD) patients remains unclear. We aimed to provide an assessment of dyspnea in COPD patients according to their Body Mass Index (BMI) and to investigate the impact of obesity on dyspnea according to COPD severity. Methods One hundred and twenty seven COPD patients with BMI ≥ 18.5 kg/m² (63% male, median (interquartile range) post bronchodilator forced expiratory volume of 1 second (post BD FEV1) at 51 (34-66) % pred) were consecutively included. Dyspnea was assessed by mMRC (Modified medical research council) scale. Lung function tests were recorded, and emphysema was quantified on CT-scan (computed tomography-scan). Results Twenty-five percent of the patients were obese (BMI ≥ 30kg/m²), 66% of patients experienced disabling dyspnea (mMRC ≥ 2). mMRC scores did not differ depending on BMI categories (2 (1-3) for normal weight, 2 (1-3) 1 for overweight and 2 (1-3) for obese patients; p = 0.71). Increased mMRC scores (0-1 versus 2-3 versus 4) were associated with decreased post BD-FEV1 (p < 0.01), higher static lung hyperinflation (inspiratory capacity/total lung capacity (IC/TLC), p < 0.01), reduced DLCO (p < 0.01) and higher emphysema scores (p < 0.01). Obese patients had reduced static lung hyperinflation (IC/TLC p < 0.01) and lower emphysema scores (p < 0.01) than non-obese patients. mMRC score increased with GOLD grades (1-2 versus 3-4) in non-obese patients but not in obese patients, in association with a trend towards reduced static lung hyperinflation and lower emphysema scores. Conclusion By contrast with non-obese patients, dyspnea did not increase with spirometric GOLD grades in obese patients. This might be explained by a reduced lung hyperinflation related to the mechanical effects of obesity and a less severe emphysema in severe COPD patients with obesity.
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Affiliation(s)
- Alexis Dupuis
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Aurore Thierry
- Université de Reims Champagne-Ardenne, VieFra, CHU Reims, Unité d’Aide Méthodologique, Reims, F-51100, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Julien Ancel
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Valérian Dormoy
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
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50
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VITACCA M, BIANCHI L, CERIANA P, GIGLIOTTI F, MURGIA R, FUMAGALLI A, SPANEVELLO A, PIANA GLA, FORLANI S, ALIANI M, BEGHI G, MANISCALCO M, FIORENTINO G, BANFI P, PANERONI M, AMBROSINO N. Is the Rehabilitation Complexity Scale Useful in Individuals Undergoing In-Hospital Pulmonary Rehabilitation? Arch Phys Med Rehabil 2024:S0003-9993(24)01128-6. [PMID: 39047855 DOI: 10.1016/j.apmr.2024.07.009] [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: 10/18/2023] [Revised: 07/11/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To assess validity and responsiveness of the Extended Rehabilitation Complexity Scale (RCS-E v13) to in-hospital pulmonary rehabilitation (PR) in individuals with chronic respiratory diseases (CRD). DESIGN Cross-sectional, multicentric study. Assessments in individuals attending units on 2 nonconsecutive days. SETTING Fourteen in-hospital PR units. PARTICIPANTS Five hundred forty-seven individuals (59.2% male, age 72y [range, 65-78y]): 317 with chronic respiratory failure because of various causes (CRF); 96 with chronic obstructive pulmonary disease without CRF (COPD), 39 tracheostomized and ventilated (TX/V), and 95 with other diseases (Miscellaneous). INTERVENTION Assessment of RCS-E v13 before and after the PR program. MAIN OUTCOME MEASURES RCS-E v13 and outcome measures: Barthel Index (BI), Barthel Index Dyspnea (BiD), Medical Research Council scale for dyspnea (MRC), COPD Assessment Test (CAT), Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). RESULTS The highest RCS-E v13 admission values (median [interquartile range]) were found in TX/V (17 [15-18]) as compared with other groups (8 [7-10], 10 [9-12], and 8 [8-10] in COPD, CRF, and Miscellaneous, respectively, P<.001). At admission and discharge, RCS-E v13 correlated strongly with BI, 6MWT, and SPPB and moderately with MRC and BiD (r=.43-.60). After the program, RCS-E v13 as well as all outcome measures improved significantly in all groups (P<.001 for all). The size of improvement was different among groups according to the different variables. In the overall group, the effect size was high for changes in RCS-E v13 (Cohen's d=-2.0984), CAT (d=-1.1937), MRC (d=-1.0505), BiD (d=-.9364), and SPPB (d=.9231) whereas it was moderate for 6MWT (d=.7670) and BI (d=.6574). CONCLUSIONS RCS-E v13 varies according to different CRD, is responsive to PR, has good construct and concurrent validity, and correlates with most of the accepted outcome measures of PR. Its scoring may provide useful information on the care burden of individuals undergoing PR.
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