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Mamipour H, Hoseini SA, Negahban H, Moradi A, Hojjati A, Rezaeitalab F, Torshizian M, Mehrali A, Parsa M, Kardan I, Tabesh H, Hassankhani EG, Akbarzadeh A. The effect of using the hip exoskeleton assistive (HEXA) robot compared to conventional physiotherapy on clinical functional outcomes in stroke patients with hemiplegia: a pilot randomized controlled trial. BMC Biomed Eng 2024; 6:7. [PMID: 39085924 PMCID: PMC11293188 DOI: 10.1186/s42490-024-00082-0] [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: 03/03/2024] [Accepted: 06/07/2024] [Indexed: 08/02/2024] Open
Abstract
TRIAL DESIGN This study is a pilot randomized clinical trial aimed to investigate the effect of using Hip Exoskeleton Assistive (HEXA) robot compared to conventional physiotherapy on the quality of walking, disability, and quality of life of stroke patients with hemiplegia. METHODS In this study, 24 patients were randomly assigned to the intervention group (robotic physiotherapy with HEXA robot), or control group (conventional physiotherapy). In each session, both groups received 30 min of conventional physiotherapy including electrotherapy and conventional exercises, and then the intervention group did gait training for 30 min with the HEXA robot and the control group for 30 min without the HEXA robot. The treatment program was 12 sessions, 3 times a week. Before the 1st and after the 12th sessions, both groups were evaluated for walking quality, disability, and quality of life. RESULTS The results showed that the main effect of time was significant (P < 0.05) in all outcomes and patients in both groups achieved significant improvement in all outcomes after the intervention. The main effect of the group was also significant in the outcomes of 6MWT (P < 0.05) and TUG (P < 0.05), and the intervention group patients experienced more distance and speed in these two tests. This study was approved by the ethics committee of Mashhad University of Medical Sciences (IR.MUMS.FHMPM.REC.1400.079 dated 28th Jan 2022). The trial was registered with the clinical trials site of www.IRCT.ir (IRCT20210730052024N1) on January 28th 2022. CONCLUSION It seems that the HEXA robot can effectively improve walking capacity and speed.
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Affiliation(s)
- Hamed Mamipour
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ali Hoseini
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hojjati
- Center of Advance Rehabilitation and Robotics Research (FUM-CARE), Mechanical Engineering Department, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Fariborz Rezaeitalab
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadreza Torshizian
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arefeh Mehrali
- Department of Physical Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Parsa
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Iman Kardan
- Center of Advance Rehabilitation and Robotics Research (FUM-CARE), Mechanical Engineering Department, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hamed Tabesh
- Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Alireza Akbarzadeh
- Center of Advance Rehabilitation and Robotics Research (FUM-CARE), Mechanical Engineering Department, Ferdowsi University of Mashhad, Mashhad, Iran
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Fucarino A, Fabbrizio A, Garrido ND, Iuliano E, Reis VM, Sausa M, Vilaça-Alves J, Zimatore G, Baldari C, Macaluso F, Giorgio AD, Cantoia M. Emerging Technologies and Open-Source Platforms for Remote Physical Exercise: Innovations and Opportunities for Healthy Population-A Narrative Review. Healthcare (Basel) 2024; 12:1466. [PMID: 39120170 PMCID: PMC11312124 DOI: 10.3390/healthcare12151466] [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: 06/08/2024] [Revised: 07/15/2024] [Accepted: 07/21/2024] [Indexed: 08/10/2024] Open
Abstract
The emergence of tele-exercise as a response to the impact of technology on physical activity has opened up new possibilities for promoting physical health. By integrating innovative technologies and open-source platforms, tele-exercise encourages people to stay active. In our latest analysis, we delved into the scientific literature surrounding the use of tele-exercise technologies in training healthy individuals. After conducting an extensive search on the PubMed database using the keywords "tele-exercise" and "physical activity" (from 2020 to 2023), we identified 44 clinical trials that were applicable to tele-exercise, but less than 10% of them were aimed at healthy individuals, precisely 9.09% (four out of forty-four studies analyzed). Our review highlights the potential of tele-exercise to help maintain physical fitness and psychological well-being, especially when traditional fitness facilities are not an option. We also underscore the importance of interoperability, standardization, and the incorporation of biomechanics, exercise physiology, and neuroscience into the development of tele-exercise platforms. Nevertheless, despite these promising benefits, research has shown that there is still a significant gap in the knowledge concerning the definition and evaluation of training parameters for healthy individuals. As a result, we call for further research to establish evidence-based practices for tele-exercise in the healthy population.
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Affiliation(s)
- Alberto Fucarino
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Antonio Fabbrizio
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Nuno D. Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal; (N.D.G.); (V.M.R.); (J.V.-A.)
| | - Enzo Iuliano
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal; (N.D.G.); (V.M.R.); (J.V.-A.)
| | - Martina Sausa
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - José Vilaça-Alves
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal; (N.D.G.); (V.M.R.); (J.V.-A.)
- Sciences Departament, University of Tra’s-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Giovanna Zimatore
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Filippo Macaluso
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Andrea De Giorgio
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Manuela Cantoia
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
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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] [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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Cui S, Ji H, Li L, Zhu H, Li X, Gong Y, Song Y, Hu L, Wu X. Effects and long-term outcomes of endurance versus resistance training as an adjunct to standard medication in patients with stable COPD: a multicenter randomized trial. BMC Pulm Med 2024; 24:196. [PMID: 38649893 PMCID: PMC11036716 DOI: 10.1186/s12890-024-03010-z] [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: 07/20/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Comparisons between endurance training (ET) and resistance training (RT) have produced equivocal findings in chronic obstructive pulmonary disease (COPD) patients. The purpose of our study is to investigate the effectiveness and long-term outcomes of adding ET and RT to conventional medical treatment in patients with COPD. A secondary objective is to investigate the clinical improvements resulting from exercise training in patients with different disease severities. METHODS The study was a multicenter, prospective trial in people with stable COPD. The cohort was randomized to three groups: individualized medical treatment group (MT), MT + endurance training group (MT + ET) and MT + resistance training group (MT + RT). Exercise was performed 3 times weekly over a 12-week period. The endpoints of exercise capacity, health-related quality of life, COPD symptoms, lung function, and anxiety and depression questionnaires were re-evaluated at baseline, at the completion of the intervention and at 6 and 12-month follow-up. According to the COPD assessment tool offered by GOLD guidelines, patients were stratified into GOLD A and B groups and GOLD C and D groups for further subgroup analysis. RESULTS The intention-to-treat (ITT) population included 366 patients, 328 of them completed the study protocol over 12 months (the PP-population). There were no significant differences in the primary outcome, quality of life, between patients who underwent medical treatment (MT) alone, MT + endurance training (MT + ET), or MT + resistance training (MT + RT) at the completion of the intervention, 6-, or 12-month follow-up. Additionally, no significant differences were observed between MT, MT + RT, or MT + ET groups concerning the primary outcome, exercise capacity (3MWD), after initial 3 months of intervention. However, a small statistically significant difference was noted in favor of MT + ET compared to MT + RT at 12 months (ITT: Δ3MWD in ET vs RT = 5.53 m, 95% confidence interval: 0.87 to 13.84 m, P = 0.03) (PP: Δ3MWD in ET vs RT = 7.67 m, 95% confidence interval: 0.93 to 16.27 m, P = 0.04). For patients in the GOLD C and D groups, improvement in quality of life following ET or RT was significantly superior to medical intervention alone. Furthermore, upon completion of the exercise regimen, RT exhibited a greater improvement in anxiety compared to ET in these patients (ITT: ΔHAD-A at 3-month: RT = -1.63 ± 0.31 vs ET = -0.61 ± 0.33, p < 0.01) (PP: ΔHAD-A at 3-month: RT = -1.80 ± 0.36 vs ET = -0.75 ± 0.37, p < 0.01). CONCLUSIONS Our study presents evidence of the beneficial effects of ET and RT in combination with standard medical treatment, as well as the long-term effects over time after the intervention. While the statistically significant effect favoring ET over RT in terms of exercise capacity was observed, it should be interpreted cautiously. Patients in severe stages of COPD may derive greater benefits from either ET or RT and should be encouraged accordingly. These findings have implications for exercise prescription in patients with COPD. TRIAL REGISTRATION ChiCTR-INR-16009892 (17, Nov, 2016).
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Affiliation(s)
- Shilei Cui
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Haiying Ji
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Shanghai Respiratory Research Institute, Shanghai, 200032, China
| | - Li Li
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Shanghai Respiratory Research Institute, Shanghai, 200032, China
| | - Huili Zhu
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Xiangyang Li
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Ying Gong
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China
- Shanghai Respiratory Research Institute, Shanghai, 200032, China
| | - Yuanlin Song
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.
- Shanghai Respiratory Research Institute, Shanghai, 200032, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200032, China.
| | - Lijuan Hu
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.
- Shanghai Respiratory Research Institute, Shanghai, 200032, China.
| | - Xu Wu
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.
- Shanghai Respiratory Research Institute, Shanghai, 200032, China.
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Muacevic A, Adler JR. Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease Treated With Tele-Yoga Versus Tele-Pulmonary Rehabilitation: A Pilot Validation Study. Cureus 2022; 14:e30994. [PMID: 36475207 PMCID: PMC9716046 DOI: 10.7759/cureus.30994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 01/25/2023] Open
Abstract
Background In chronic obstructive pulmonary disease (COPD), pulmonary rehabilitation (PR) is an integral component of the non-pharmacological management of COPD. Yoga has proven to be beneficial in COPD, although well-designed comparative studies between the two modalities are lacking. This pilot study aims to compare these two modalities delivered as supervised tele-intervention. Methods The outpatient department (OPD) of a tertiary hospital recruited consenting, consecutive, inclusion-eligible COPD participants who were randomly assigned to intervention and control arms of 30 patients each. The intervention arm received a 45-minute tele-yoga therapy module (T-YT) validated by content validity ratio (CVR), computed using Lawshe's methodology and responses from 24 yoga specialists. The control arm received a 45-minute standardized tele-pulmonary rehabilitation session (T-PR). T-YT and T-PR were both managed through an online portal. Exercise capacity as measured by the six-minute walk distance (6MWD), symptom score (COPD assessment test [CAT], modified medical research council [mMRC]), forced expiratory volume in one second (FEV1%), quality of life (QoL) scores, St. George respiratory questionnaire (SGRQ), depression and anxiety scores (patient health questionnaire [PHQ-9] and generalized anxiety disorder scale [GAD-7] scores), were recorded at baseline and at the end of three months. Results 6MWD, symptom scores, SGRQ, PHQ-9, and GAD-7 all improved significantly from baseline within each group, but there was no statistically significant difference between the groups. FEV1% did not differ significantly between or among groups. This study shows T-YT module can be a reasonable substitute for T-PR in patients with COPD. Conclusions T-YT is beneficial in patients of COPD in terms of exercise capacity, symptom scores, and depression and anxiety scores and can be a reasonable alternative to T-PR.
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Stavarache IE, Buculei I, Cernomaz A, Vicol C, Dabija RAC, Trofor AC. Role of pulmonary rehabilitation in chronic obstructive pulmonary disease - a historical perspective. Med Pharm Rep 2022; 95:475-485. [PMID: 36506604 PMCID: PMC9694745 DOI: 10.15386/mpr-2498] [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: 02/11/2022] [Revised: 06/16/2022] [Accepted: 07/06/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Pulmonary rehabilitation is known as an effective therapy for patients with chronic obstructive pulmonary disease (COPD). This article is a brief introduction into the history of medical and pulmonary rehabilitation, presenting the evolution of applied therapies and methods from ancient to present times. It also highlights the role of physical effort in the prevention and treatment of lung diseases, with special consideration to COPD. Methods For this literature review, the international databases Medline and Scopus were used to identify relevant articles, between January 1981 to December 2021; eighty articles were considered: thirty-six reviews, eight original research and six general articles which met the criteria for inclusion. A total of thirty references were excluded because they were not relevant. Results Available published data suggest a rich history of rehabilitation reaching for thousands of years even though it was developed as a medical branch only in the 20th century. Pulmonary rehabilitation is currently an important component of the management of COPD patients, with a positive impact on symptoms, frequency of exacerbations, severity and mortality rates. Conclusions Even though this type of intervention is known to be beneficial for this type of patients more studies need to be conducted in this field.
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Affiliation(s)
| | - Ioana Buculei
- "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Andrei Cernomaz
- "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Cristina Vicol
- "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
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Song CY, Liu X, Wang YQ, Cao HP, Yang Z, Ma RC, Yin YY, Xie J. Effects of home-based telehealth on the physical condition and psychological status of patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Int J Nurs Pract 2022:e13062. [PMID: 35545098 DOI: 10.1111/ijn.13062] [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: 11/03/2019] [Revised: 04/15/2022] [Accepted: 04/27/2022] [Indexed: 11/28/2022]
Abstract
AIMS This systematic review and meta-analysis aimed to evaluate the effects of home-based telehealth compared with usual care on six-minute walking distance (6MWD), health-related quality of life, anxiety and depression in patients with chronic obstructive pulmonary disease. METHODS We identified randomized controlled trials through a systematic multidatabase search. Titles and abstracts were assessed for relevance. Two authors independently extracted data and assessed the risk of bias and quality of evidence. Meta-analyses were conducted using Review Manager and Stata. RESULTS We included 32 randomized controlled trials (n = 5232). Devices used for home-based telehealth interventions included telephones, videos, and combined devices. The quality of the evidence was downgraded due to high risk of bias, imprecision, and inconsistency. Home-based telehealth significantly increased 6MWD by 35 m (SD = 30.42) and reduced symptom burden by 3 points (SD = -2.30) on the COPD assessment test compared with usual care. However, no significant differences in anxiety and depression were noted between the home-based telehealth group and the standard care group. In subgroup analysis, home-based telehealth significantly improved 6MWD and health status after 6-12 months and >12 months. CONCLUSION Low quality evidence showed that home-based telehealth interventions reduce symptom burden and increase walking distance to a clinically meaningful extent in patients with COPD. However, no effects on depression and anxiety were observed.
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Affiliation(s)
- Chun-Yu Song
- School of Nursing, Jilin University, Changchun, China
| | - Xin Liu
- School of Nursing, Jilin University, Changchun, China
| | - Ya-Qing Wang
- School of Nursing, Jilin University, Changchun, China
| | - Hui-Ping Cao
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Zhuo Yang
- Department of Emergency, The First Hospital of Jilin University, Changchun, China
| | - Rui-Chen Ma
- School of Nursing, Jilin University, Changchun, China
| | - Ying-Ying Yin
- School of Nursing, Jilin University, Changchun, China
| | - Jiao Xie
- School of Nursing, Jilin University, Changchun, China
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Anlló H, Herer B, Delignières A, Ghergan A, Bocahu Y, Segundo I, Moulin C, Larue F. Hypnosis for the Management of COPD-related anxiety and dyspnea in Pulmonary Rehabilitation - rationale and design for a cluster-randomised, active-control trial [HYPNOBPCO_2]. ERJ Open Res 2022; 8:00565-2021. [PMID: 35141317 PMCID: PMC8819244 DOI: 10.1183/23120541.00565-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
Complementary psychological care is recommended for COPD, as it significantly reduces anxiety and boosts the pulmonary rehabilitation efficacy. In a precedent trial (HYPNOBPCO_1, ISRCTN10029862), administering a single hypnosis session was linked to reduced anxiety and improved breathing mechanics in intermediate and advanced COPD patients. However, whether hypnosis could improve self-management of anxiety and dyspnoea in COPD during pulmonary rehabilitation is yet to be investigated. This is the protocol for HYPNOBPCO_2, a 2-arm, cluster-randomised, statistician-blinded superiority monocentre trial (NCT04868357). Its aim is to assess the efficacy of hypnosis as a tool to manage anxiety and dyspnoea during a pulmonary rehabilitation programme (PRP). Clusters of COPD patients eligible for the conventional hospital-based PRP at the Centre Hospitalier de Bligny (CHB) will be randomised and evenly allocated into two parallel arms: “Hypnosis” (treatment) and “Relaxation” (active control). “Hypnosis” will consist of the CHB's conventional 4-week group PRP, supplemented by two educational sessions for teaching self-hypnosis. “Relaxation” will be identical, except standard relaxation exercises will be taught instead. Primary end-point will consist of assessing weekly changes in anxiety throughout the PRP, additional to total anxiety change after treatment completion. Anxiety will be determined by the six-item version of the State-Trait Anxiety Inventory (STAI-6). Secondary outcomes will include change in the 6-min walk test and the COPD assessment test (CAT). Further follow-up outcomes will include CAT and STAI-6 retests, re-hospitalisation rate, action plan use and persistence in self-hypnosis use, throughout the 12 weeks ensuing PRP completion. Rationale for HYPNOBPCO_2 (NCT04868357), a trial investigating whether self-hypnosis (fast, low-cost, effortless) reliably improves breathlessness-related anxiety and breathing mechanics, during and after pulmonary rehabilitation in COPDhttps://bit.ly/3JF2vCW
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Amorese AJ, Ryan AS. Home-Based Tele-Exercise in Musculoskeletal Conditions and Chronic Disease: A Literature Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:811465. [PMID: 36188988 PMCID: PMC9397976 DOI: 10.3389/fresc.2022.811465] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/28/2022] [Indexed: 01/28/2023]
Abstract
Exercise training is an essential component in the treatment or rehabilitation of various diseases and conditions. However, barriers to exercise such as the burdens of travel or time may hinder individuals' ability to participate in such training programs. Advancements in technology have allowed for remote, home-based exercise training to be utilized as a supplement or replacement to conventional exercise training programs. Individuals in these home-based exercise programs are able to do so under varying levels of supervision from trained professionals, with some programs having direct supervision, and others having little to no supervision at all. The purpose of this review is to examine the use of home-based, tele-exercise training programs for the treatment of different disease states and conditions, and how these programs compare to conventional clinic-based exercise training programs.
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Affiliation(s)
- Adam J Amorese
- Baltimore Veterans Affairs (VA) Medical Center, Geriatric Research, Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, MD, United States
| | - Alice S Ryan
- Baltimore Veterans Affairs (VA) Medical Center, Geriatric Research, Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, MD, United States.,VA Research Service, Baltimore GRECC, Department of Medicine, Division of Geriatrics and Palliative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
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Pehlivan E, Palalı İ, Atan S, Turan D, Çınarka H, Çetinkaya E. The effectiveness of POST-DISCHARGE telerehabilitation practices in COVID-19 patients: Tele-COVID study-randomized controlled trial. Ann Thorac Med 2022; 17:110-117. [PMID: 35651892 PMCID: PMC9150661 DOI: 10.4103/atm.atm_543_21] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/08/2022] [Indexed: 11/04/2022] Open
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11
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Cerdán-de-las-Heras J, Balbino F, Løkke A, Catalán-Matamoros D, Hilberg O, Bendstrup E. Effect of a New Tele-Rehabilitation Program versus Standard Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2021; 11:jcm11010011. [PMID: 35011755 PMCID: PMC8745243 DOI: 10.3390/jcm11010011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/22/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022] Open
Abstract
In chronic obstructive pulmonary disease (COPD), rehabilitation is recommended, but attendance rates are low. Tele-rehabilitation may be key. We evaluate the effect of a tele-rehabilitation program vs. standard rehabilitation on COPD. A randomized, non-inferiority study comparing eight weeks of tele-rehabilitation (physiotherapist video/chat-consultations and workout sessions with a virtual-autonomous-physiotherapist-agent (VAPA)) and standard rehabilitation in stable patients with COPD. At baseline, after 8 weeks and 3 and 6 months of follow-up, 6 min walk test distance (6MWTD), 7-day pedometry, quality of life, exercise tolerance, adherence, patient satisfaction and safety were assessed. Fifty-four patients (70 ± 9 years, male 57%, FEV1% 34.53 ± 11.67, FVC% 68.8 ± 18.81, 6MWT 376.23 ± 92.02) were included. Twenty-seven patients were randomized to tele-rehabilitation. Non-inferiority in Δ6MWTD at 8 weeks (47.4 ± 31.4), and at 3 (56.0 ± 38.0) and 6 (95.2 ± 47.1) months follow-up, was observed. No significant difference was observed in 7-day pedometry or quality of life. In the intervention group, 6MWTD increased by 25% and 66% at 3 and 6 months, respectively; adherence was 81%; and patient satisfaction was 4.27 ± 0.77 (Likert scale 0-5). Non-inferiority between groups and high adherence, patient satisfaction and safety in the intervention group were found after rehabilitation and at 3 and 6 months of follow-up. Tele-rehabilitation with VAPA seems to be a promising alternative.
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Affiliation(s)
- Jose Cerdán-de-las-Heras
- Department of Respiratory Diseases and Allergy, Center for Rare Lung Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark;
- Department of Research and Development, Physio R&D ApS, 2000 Frederiksberg, Denmark;
- Correspondence: ; Tel.: +45-30-64-82-83
| | - Fernanda Balbino
- Department of Research and Development, Physio R&D ApS, 2000 Frederiksberg, Denmark;
| | - Anders Løkke
- Department of Respiratory Medicine, Vejle Hospital, 7100 Vejle, Denmark; (A.L.); (O.H.)
| | - Daniel Catalán-Matamoros
- Department of Communication and Media Studies, UC3M Medialab, Madrid University Carlos III, 28903 Madrid, Spain;
- Health Research Centre, University of Almeria, 04120 Almeria, Spain
| | - Ole Hilberg
- Department of Respiratory Medicine, Vejle Hospital, 7100 Vejle, Denmark; (A.L.); (O.H.)
| | - Elisabeth Bendstrup
- Department of Respiratory Diseases and Allergy, Center for Rare Lung Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark;
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12
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Cerdán-de-las-Heras J, Balbino F, Løkke A, Catalán-Matamoros D, Hilberg O, Bendstrup E. Tele-Rehabilitation Program in Idiopathic Pulmonary Fibrosis-A Single-Center Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910016. [PMID: 34639313 PMCID: PMC8508000 DOI: 10.3390/ijerph181910016] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022]
Abstract
We investigated the usefulness and effectiveness of tele-rehabilitation on exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). A randomized study was carried out, including stable patients with IPF for 3 months of tele-rehabilitation: video and chat consultations with a physiotherapist and workout sessions with a virtual physiotherapist agent (VAPA). Moreover, 6-min walk test distance (6MWTD), forced vital capacity (FVC), diffusion capacity for carbon monoxide (DLCO), 7 days pedometry, Saint George Respiratory Questionnaire for interstitial lung disease, The King’s Brief Interstitial Lung Disease Questionnaire, and General Anxiety Disorder 7 Questionnaire were tested before and after 3 months of tele-rehabilitation, as well as after 3 and 6 months follow-up. Patient satisfaction and adherence were also measured for tele-rehabilitation with VAPA. Twenty-nine patients aged 70.9 ± 8.6 years, male 72.4%, FVC% 83.5 ± 17.7, DLCO% 50.6 ± 13.0, 6MWTD 468.4 ± 14.8 were included. Fifteen patients were randomized to tele-rehabilitation with VAPA and 14 to the control group. Differences in 6MWTD between groups were at baseline (+10 m (p = 0.11)) and after 3 (+39.5 m (p = 0.03)), 6 (+34.3 m (p = 0.02)), and 9 months (+40.5 m (p = 0.15)) follow-up. No difference was observed in pedometry and quality of life. Adherence was above 63%. Patient satisfaction was high. Tele-rehabilitation with VAPA appears to be useful in patients with IPF. Exercise capacity was better at follow up at 3 and 6 months compared with the control group. There was no change in quality of life or pedometry. Adherence and patient satisfaction were all high.
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Affiliation(s)
- Jose Cerdán-de-las-Heras
- Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark;
- Correspondence: ; Tel.: +45-30-64-82-83
| | - Fernanda Balbino
- Department of Research and Development, Physio R&D ApS, 2000 Frederiksberg, Denmark;
| | - Anders Løkke
- Department of Respiratory Medicine, Vejle Hospital, 7100 Vejle, Denmark; (A.L.); (O.H.)
| | - Daniel Catalán-Matamoros
- UC3M Medialab, Department of Communication and Media Studies, Madrid University Carlos III, 28903 Madrid, Spain;
- Health Research Centre, University of Almeria, 04120 Almeria, Spain
| | - Ole Hilberg
- Department of Respiratory Medicine, Vejle Hospital, 7100 Vejle, Denmark; (A.L.); (O.H.)
| | - Elisabeth Bendstrup
- Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark;
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13
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Poot CC, Meijer E, Kruis AL, Smidt N, Chavannes NH, Honkoop PJ. Integrated disease management interventions for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2021; 9:CD009437. [PMID: 34495549 PMCID: PMC8425271 DOI: 10.1002/14651858.cd009437.pub3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND People with chronic obstructive pulmonary disease (COPD) show considerable variation in symptoms, limitations, and well-being; this often complicates medical care. A multi-disciplinary and multi-component programme that addresses different elements of care could improve quality of life (QoL) and exercise tolerance, while reducing the number of exacerbations. OBJECTIVES To compare the effectiveness of integrated disease management (IDM) programmes versus usual care for people with chronic obstructive pulmonary disease (COPD) in terms of health-related quality of life (QoL), exercise tolerance, and exacerbation-related outcomes. SEARCH METHODS We searched the Cochrane Airways Group Register of Trials, CENTRAL, MEDLINE, Embase, and CINAHL for potentially eligible studies. Searches were current as of September 2020. SELECTION CRITERIA Randomised controlled trials (RCTs) that compared IDM programmes for COPD versus usual care were included. Interventions consisted of multi-disciplinary (two or more healthcare providers) and multi-treatment (two or more components) IDM programmes of at least three months' duration. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data. If required, we contacted study authors to request additional data. We performed meta-analyses using random-effects modelling. We carried out sensitivity analyses for the quality of included studies and performed subgroup analyses based on setting, study design, dominant intervention components, and region. MAIN RESULTS Along with 26 studies included in the 2013 Cochrane Review, we added 26 studies for this update, resulting in 52 studies involving 21,086 participants for inclusion in the meta-analysis. Follow-up periods ranged between 3 and 48 months and were classified as short-term (up to 6 months), medium-term (6 to 15 months), and long-term (longer than 15 months) follow-up. Studies were conducted in 19 different countries. The mean age of included participants was 67 years, and 66% were male. Participants were treated in all types of healthcare settings, including primary (n =15), secondary (n = 22), and tertiary care (n = 5), and combined primary and secondary care (n = 10). Overall, the level of certainty of evidence was moderate to high. We found that IDM probably improves health-related QoL as measured by St. George's Respiratory Questionnaire (SGRQ) total score at medium-term follow-up (mean difference (MD) -3.89, 95% confidence interval (CI) -6.16 to -1.63; 18 RCTs, 4321 participants; moderate-certainty evidence). A comparable effect was observed at short-term follow-up (MD -3.78, 95% CI -6.29 to -1.28; 16 RCTs, 1788 participants). However, the common effect did not exceed the minimum clinically important difference (MCID) of 4 points. There was no significant difference between IDM and control for long-term follow-up and for generic QoL. IDM probably also leads to a large improvement in maximum and functional exercise capacity, as measured by six-minute walking distance (6MWD), at medium-term follow-up (MD 44.69, 95% CI 24.01 to 65.37; 13 studies, 2071 participants; moderate-certainty evidence). The effect exceeded the MCID of 35 metres and was even greater at short-term (MD 52.26, 95% CI 32.39 to 72.74; 17 RCTs, 1390 participants) and long-term (MD 48.83, 95% CI 16.37 to 80.49; 6 RCTs, 7288 participants) follow-up. The number of participants with respiratory-related admissions was reduced from 324 per 1000 participants in the control group to 235 per 1000 participants in the IDM group (odds ratio (OR) 0.64, 95% CI 0.50 to 0.81; 15 RCTs, median follow-up 12 months, 4207 participants; high-certainty evidence). Likewise, IDM probably results in a reduction in emergency department (ED) visits (OR 0.69, 95%CI 0.50 to 0.93; 9 RCTs, median follow-up 12 months, 8791 participants; moderate-certainty evidence), a slight reduction in all-cause hospital admissions (OR 0.75, 95%CI 0.57 to 0.98; 10 RCTs, median follow-up 12 months, 9030 participants; moderate-certainty evidence), and fewer hospital days per person admitted (MD -2.27, 95% CI -3.98 to -0.56; 14 RCTs, median follow-up 12 months, 3563 participants; moderate-certainty evidence). Statistically significant improvement was noted on the Medical Research Council (MRC) Dyspnoea Scale at short- and medium-term follow-up but not at long-term follow-up. No differences between groups were reported for mortality, courses of antibiotics/prednisolone, dyspnoea, and depression and anxiety scores. Subgroup analysis of dominant intervention components and regions of study suggested context- and intervention-specific effects. However, some subgroup analyses were marked by considerable heterogeneity or included few studies. These results should therefore be interpreted with caution. AUTHORS' CONCLUSIONS This review shows that IDM probably results in improvement in disease-specific QoL, exercise capacity, hospital admissions, and hospital days per person. Future research should evaluate which combination of IDM components and which intervention duration are most effective for IDM programmes, and should consider contextual determinants of implementation and treatment effect, including process-related outcomes, long-term follow-up, and cost-effectiveness analyses.
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Affiliation(s)
- Charlotte C Poot
- Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Eline Meijer
- Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Annemarije L Kruis
- Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Persijn J Honkoop
- Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Leiden, Netherlands
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14
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Cardiac Ultrasound under Speckle Tracking Technology Based Analysis of Efficacy of Respiratory Rehabilitation on Chronic Obstructive Pulmonary Disease. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7569908. [PMID: 34422246 PMCID: PMC8376426 DOI: 10.1155/2021/7569908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/06/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022]
Abstract
The study shined spotlight on the effect of respiratory rehabilitation training on chronic obstructive pulmonary disease (COPD), which was evaluated using speckle ultrasound algorithm-based cardiac ultrasound. Then, 90 patients with stable COPD, who were admitted to the hospital from January 2018 to December 2019, were randomly rolled into three groups, namely, the fast inhalation and slow exhalation (A) group, abdominal breathing (B) group, and control (C) group. For group A, on the basis of the conventional treatment, the method of rapid inhalation and slow exhalation was adopted. The group B (n = 30) adopted the abdominal breathing method besides the conventional treatment. In addition, the group C (n = 30) received only conventional treatment. Finally, the efficacy and parameters of the three treatment methods were compared. The echocardiographic parameters and echocardiographic images were calculated and processed by the speckle tracking method. Three kinds of operators were used to track the myocardial spots successfully, and the corresponding points in the image were obtained and calculated. It was found that there was no significant difference in the degree of dyspnea, exercise endurance, lung function, respiratory muscle function, and quality of life (QOL) before treatment (P > 0.05). After treatment, in contrast with group C, the previously mentioned indicators in groups A and B were obviously better (P < 0.05). Further, both the echocardiographic images and echocardiographic parameters of groups A and B were obviously improved, and there was no obvious difference between groups A and B. Hence, some degree of respiratory rehabilitation was very effective in the diagnosis of patients with chronic pulmonary obstruction. In conclusion, the speckle tracking algorithm-based cardiac ultrasound improves the image quality. At the same time, respiratory rehabilitation training is effective on COPD and worthy of clinical promotion.
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15
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Hansen H, Beyer N, Frølich A, Godtfredsen N, Bieler T. Inter-Day Test-Retest Reproducibility of the CAT, CCQ, HADS and EQ-5D-3L in Patients with Severe and Very Severe COPD. PATIENT-RELATED OUTCOME MEASURES 2021; 12:117-128. [PMID: 34104024 PMCID: PMC8179805 DOI: 10.2147/prom.s306352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/30/2021] [Indexed: 11/23/2022]
Abstract
Introduction In patients with COPD, the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and EuroQol 5D (EQ-5D-3L) are widely used patient reported outcome measures (PROMs) of respiratory symptoms, anxiety, depression and quality of life. Despite established validity, responsiveness and minimal important change (MIC), the reproducibility and especially important agreement parameters remain unreported in these frequently used PROMs. The aim of this study was to investigate the inter-day test–retest reliability and agreement of the CAT, CCQ, HADS and EQ-5D-3L in patients with severe and very severe COPD (FEV1 <50%) eligible for hospital-based pulmonary rehabilitation. Patients and Methods Fifty patients (22 females, mean [SD] age 67 [9] yrs.; FEV1 32[9] %; 6-minute walk distance 347 [102] meters; CAT 21 [6] points; BMI: 26 [6] kg/m2) completed the questionnaires (CAT, CCQ, HADS, EQ-5D-3L) in combination with functional performance test instructed by one assessor on test-day one (T1) and by another assessor 7–10 days later on test-day two (T2). Results The inter-day test–retest reliability ICC was 0.88 (LL95CI: 0.80) for CAT; 0.69 (LL95CI: 0.46) for CCQ; 0.86 (LL95CI: 0.75) and 0.90 (LL95CI: 0.82) for HADS-anxiety (A) and depression (D) and 0.87 (LL95CI: 0.76) for EQ-5D-VAS. The corresponding agreements within a single measurement (standard error of measurement, SEM) and for repeated measurement errors (smallest real difference, SRD) were respectively 2.1 and 2.9 points for CAT; 0.5 and 0.7 points for CCQ total; 1.3 and 1.9 points for HADS-A; 0.9 and 1.3 points for HADS-D and 6.8 and 9.7 VAS-score for EQ-5D-3L, respectively. Ceiling/flooring effect was present in <5% for all questionnaires. Conclusion In patients with severe and very severe COPD, the CAT, CCQ, HADS and EQ-5D-3L questionnaires presented moderate to excellent inter-day test–retest reliability, and no floor or ceiling effect was documented for any of the questionnaires. Only CAT and HADS had an acceptable SRD below the established MIC for assessing change over time on group level, and none of the PROMS were fit to assess individual changes over time.
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Affiliation(s)
- Henrik Hansen
- Department of Respiratory Medicine, Respiratory Research Unit, Hvidovre University Hospital, Hvidovre, Denmark
| | - Nina Beyer
- Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Frølich
- Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Slagelse, Denmark.,Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nina Godtfredsen
- Department of Respiratory Medicine, Respiratory Research Unit, Hvidovre University Hospital, Hvidovre, Denmark.,Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Theresa Bieler
- Department of Physical & Occupational Therapy, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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16
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Rayce K, Huniche L, Kidholm K, Vestbo J, Pedersen CD, Minet LR. Transformations of practice in online exercise training for patients with COPD led by physiotherapists - a qualitative study. Disabil Rehabil 2021; 44:4784-4793. [PMID: 33984258 DOI: 10.1080/09638288.2021.1921063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to characterize the practice of telemediated training for patients with very severe Chronic Obstructive Pulmonary Disease (COPD) and to inform the development of clinical/professional practice. METHODS Inspired by ethnographic methodology, participating observation, informal and formal interviews were conducted with patients (11), their partners (4), and physiotherapists (6) at sites where the telemediated training was practiced. Postphenomenology was used as theoretical and analytical framework. RESULTS Telemediated training in the homes of the patients takes place where most daily activities happen, and together with activities in the rehabilitation units they are included in the training in a reduced or amplified version that may compromise the privacy of the patients. The mediated image and sound challenge the training and communication activities and the possibility for the physiotherapists to estimate the condition of the patients. Consequently, the physiotherapists lower how much they push the patients in the exercises. CONCLUSIONS Making training accessible to very severely ill patients with COPD through homebased telemediation comes with several trade-offs. This study can be used to educate clinical practice before and during the practicing of telemediated services, which need to be organized in a way that allows continuous adjustment.IMPLICATIONS FOR PRACTICEThe technology itself is not a neutral device in online health care provision. Health professionals should therefore:Play an active role in structuring the content, communication, and inclusion of the patients' context during online health care provision.Receive training in how to spot ways in which online health care provision transforms traditional practice and to how to work around its limitations.Organize online health care practices in ways that allow for continuous adjustment (for which they need back up from management).
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Affiliation(s)
- Kathrine Rayce
- Centre for Innovative Medical Technology (CIMT), Odense University Hospital, Odense, Denmark
| | - Lotte Huniche
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Kristian Kidholm
- Centre of Innovative Technology (CIMT), University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Jorgen Vestbo
- Manchester University NHS Foundation Trust, University of Manchester, Manchester, UK
| | | | - Lisbeth Rosenbek Minet
- Rehabilitation Unit, Institute of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark
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17
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Taito S, Yamauchi K, Kataoka Y. Telerehabilitation in Subjects With Respiratory Disease: A Scoping Review. Respir Care 2021; 66:686-698. [PMID: 33531356 PMCID: PMC9993993 DOI: 10.4187/respcare.08365] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Considering the current coronavirus disease (COVID-19) pandemic, telerehabilitation may be a viable first-line option for patients with respiratory tract disease. To date, there has been no systematic review on telerehabilitation for respiratory tract diseases, including COVID-19. Therefore, this scoping review aimed to determine what telerehabilitation for patients with respiratory tract diseases consists of, how safe telerehabilitation is for patients with respiratory tract diseases, and how feasible telerehabilitation is for hospitalized patients with COVID-19. In May 2020, we conducted a search of the following publication databases on the use of telerehabilitation in the treatment of respiratory tract diseases: Medical Literature Analysis and Retrieval System Online, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Literature, and Physiotherapy Evidence Database. Of the 208 articles identified, 23 studies were subsequently included in this scoping review. In 22 of the included studies, subjects had stable COPD and underwent telerehabilitation at home. The final included study was a case series of subjects with severe acute respiratory syndrome coronavirus 2 infection who underwent telerehabilitation in-hospital. Most telerehabilitation programs consisted of aerobic exercises using a cycle ergometer or a treadmill, walking, and muscle-strengthening exercises. The reported number of adverse events was low, and most studies reported that the average session adherence rate was > 70%. The majority of the telerehabilitation programs included a face-to-face rehabilitation assessment. Our findings indicate that, in its current state, telerehabilitation may be safe and feasible and may lead to reduced face-to-face rehabilitation therapy; in addition, remote rehabilitation assessment should be considered during the COVID-19 pandemic. Further research that targets a more diverse range of respiratory tract diseases and considers telerehabilitation in a hospital setting is required.
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Affiliation(s)
- Shunsuke Taito
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Kota Yamauchi
- Department of Rehabilitation, Steel Memorial Yawata Hospital, Kitakyushu, Fukuoka, Japan
| | - Yuki Kataoka
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
- Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
- Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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18
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Ding X, Clifton D, Ji N, Lovell NH, Bonato P, Chen W, Yu X, Xue Z, Xiang T, Long X, Xu K, Jiang X, Wang Q, Yin B, Feng G, Zhang YT. Wearable Sensing and Telehealth Technology with Potential Applications in the Coronavirus Pandemic. IEEE Rev Biomed Eng 2021; 14:48-70. [PMID: 32396101 DOI: 10.1109/rbme.2020.2992838] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic with serious clinical manifestations including death. A pandemic at the large-scale like COVID-19 places extraordinary demands on the world's health systems, dramatically devastates vulnerable populations, and critically threatens the global communities in an unprecedented way. While tremendous efforts at the frontline are placed on detecting the virus, providing treatments and developing vaccines, it is also critically important to examine the technologies and systems for tackling disease emergence, arresting its spread and especially the strategy for diseases prevention. The objective of this article is to review enabling technologies and systems with various application scenarios for handling the COVID-19 crisis. The article will focus specifically on 1) wearable devices suitable for monitoring the populations at risk and those in quarantine, both for evaluating the health status of caregivers and management personnel, and for facilitating triage processes for admission to hospitals; 2) unobtrusive sensing systems for detecting the disease and for monitoring patients with relatively mild symptoms whose clinical situation could suddenly worsen in improvised hospitals; and 3) telehealth technologies for the remote monitoring and diagnosis of COVID-19 and related diseases. Finally, further challenges and opportunities for future directions of development are highlighted.
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19
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12-months follow-up of pulmonary tele-rehabilitation versus standard pulmonary rehabilitation: A multicentre randomised clinical trial in patients with severe COPD. Respir Med 2020; 172:106129. [PMID: 32905893 DOI: 10.1016/j.rmed.2020.106129] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022]
Abstract
Between March 2016 and October 2017, we randomised 134 patients with severe COPD from 8 hospitals in the Capital Region of Denmark to participate in either standardised, outpatient pulmonary rehabilitation (control group) or on-line, supervised and home-based tele-rehabilitation (intervention group). We found no difference between the groups in the primary outcome: six minutes walking distance (6MWD) after completion of the programme. The current study presents results from the 12-month follow-up with assessment of the 6MWD and analyses of hospitalisation and mortality. There were no significant differences between or within the groups in the 6MWD one year after completion of the programme.
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20
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Simonÿ C, Andersen IC, Bodtger U, Nyberg M, Birkelund R. Raised illness mastering – a phenomenological hermeneutic study of chronic obstructive pulmonary disease patients’ experiences while participating in a long-term telerehabilitation programme. Disabil Rehabil Assist Technol 2020; 17:594-601. [DOI: 10.1080/17483107.2020.1804630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Charlotte Simonÿ
- Institute of the Regional Health, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Slagelse, Denmark
| | - Ingrid Charlotte Andersen
- Institute of the Regional Health, University of Southern Denmark, Odense, Denmark
- Department of Medicine, Naestved and Slagelse Hospitals, Slagelse, Denmark
| | - Uffe Bodtger
- Institute of the Regional Health, University of Southern Denmark, Odense, Denmark
- Department of Respiratory Medicine, Naestved Hospital, Naestved, Denmark
- Department of Respiratory Medicine, Roskilde Hospital, Roskilde, Denmark
| | - Mette Nyberg
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Slagelse, Denmark
| | - Regner Birkelund
- Institute of the Regional Health, University of Southern Denmark, Odense, Denmark
- Department of Health Research, Vejle Sygehus, Vejle, Denmark
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21
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Sood A, Pollard C, Suer KL, Vlahovich K, Walker J. Caring for Miners During the Coronavirus Disease-2019 (COVID-19) Pandemic. J Rural Health 2020; 37:165-168. [PMID: 32277775 PMCID: PMC7262277 DOI: 10.1111/jrh.12444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Akshay Sood
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.,Black Lung Program, Miners' Colfax Medical Center, Raton, New Mexico
| | - Charles Pollard
- Black Lung Program, Miners' Colfax Medical Center, Raton, New Mexico
| | - Kyla Le Suer
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Kevin Vlahovich
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Jolene Walker
- Critical Nurse Staffing, LLC, Grand Junction, Colorado
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22
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Burge AT, Cox NS, Abramson MJ, Holland AE. Interventions for promoting physical activity in people with chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev 2020; 4:CD012626. [PMID: 32297320 PMCID: PMC7160071 DOI: 10.1002/14651858.cd012626.pub2] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Escalating awareness of the magnitude of the challenge posed by low levels of physical activity in people with chronic obstructive pulmonary disease (COPD) highlights the need for interventions to increase physical activity participation. The widely-accepted benefits of physical activity, coupled with the increasing availability of wearable monitoring devices to objectively measure participation, has led to a dramatic rise in the number and variety of studies that aimed to improve the physical activity of people with COPD. However, little was known about the relative efficacy of interventions tested so far. OBJECTIVES In people with COPD, which interventions are effective at improving objectively-assessed physical activity? SEARCH METHODS We identified trials from the Cochrane Airways Trials Register Register, which contains records identified from bibliographic databases including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, AMED, and PsycINFO. We also searched PEDro, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform portal and the Australian New Zealand Clinical Trials Registry (from inception to June 2019). We checked reference lists of all primary studies and review articles for additional references, as well as respiratory journals and respiratory meeting abstracts, to identify relevant studies. SELECTION CRITERIA We included randomised controlled trials of interventions that used objective measures for the assessment of physical activity in people with COPD. Trials compared an intervention with no intervention or a sham/placebo intervention, an intervention in addition to another standard intervention common to both groups, or two different interventions. DATA COLLECTION AND ANALYSIS We used standard methods recommended by Cochrane. Subgroup analyses were possible for supervised compared to unsupervised pulmonary rehabilitation programmes in clinically-stable COPD for a range of physical activity outcomes. Secondary outcomes were health-related quality of life, exercise capacity, adverse events and adherence. Insufficient data were available to perform prespecified subgroup analyses by duration of intervention or disease severity. We undertook sensitivity analyses by removing studies that were at high or unclear risk of bias for the domains of blinding and incomplete outcome data. MAIN RESULTS We included 76 studies with 8018 participants. Most studies were funded by government bodies, although some were sponsored by equipment or drug manufacturers. Only 38 studies had physical activity as a primary outcome. A diverse range of interventions have been assessed, primarily in single studies, but improvements have not been systematically demonstrated following any particular interventions. Where improvements were demonstrated, results were confined to single studies, or data for maintained improvement were not provided. Step count was the most frequently reported outcome, but it was commonly assessed using devices with documented inaccuracy for this variable. Compared to no intervention, the mean difference (MD) in time in moderate- to vigorous-intensity physical activity (MVPA) following pulmonary rehabilitation was four minutes per day (95% confidence interval (CI) -2 to 9; 3 studies, 190 participants; low-certainty evidence). An improvement was demonstrated following high-intensity interval exercise training (6 minutes per day, 95% CI 4 to 8; 2 studies, 275 participants; moderate-certainty evidence). One study demonstrated an improvement following six months of physical activity counselling (MD 11 minutes per day, 95% CI 7 to 15; 1 study, 280 participants; moderate-certainty evidence), but we found mixed results for the addition of physical activity counselling to pulmonary rehabilitation. There was an improvement following three to four weeks of pharmacological treatment with long-acting muscarinic antagonist and long-acting beta2-agonist (LAMA/LABA) compared to placebo (MD 10 minutes per day, 95% CI 4 to 15; 2 studies, 423 participants; high-certainty evidence). These interventions also demonstrated improvements in other measures of physical activity. Other interventions included self-management strategies, nutritional supplementation, supplemental oxygen, endobronchial valve surgery, non-invasive ventilation, neuromuscular electrical stimulation and inspiratory muscle training. AUTHORS' CONCLUSIONS A diverse range of interventions have been assessed, primarily in single studies. Improvements in physical activity have not been systematically demonstrated following any particular intervention. There was limited evidence for improvement in physical activity with strategies including exercise training, physical activity counselling and pharmacological management. The optimal timing, components, duration and models for interventions are still unclear. Assessment of quality was limited by a lack of methodological detail. There was scant evidence for a continued effect over time following completion of interventions, a likely requirement for meaningful health benefits for people with COPD.
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Affiliation(s)
- Angela T Burge
- La Trobe UniversityDepartment of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and SportMelbourneVictoriaAustralia
- Institute for Breathing and SleepMelbourneAustralia
- Alfred HealthPhysiotherapyPO Box 315MelbourneAustraliaPrahran VIC 3181
- Monash UniversityDepartment of Allergy, Clinical Immunology and Respiratory MedicineMelbourneAustralia
| | - Narelle S Cox
- Institute for Breathing and SleepMelbourneAustralia
- Monash UniversityDepartment of Allergy, Clinical Immunology and Respiratory MedicineMelbourneAustralia
- School of Allied Health, Human Services and Sport, La Trobe UniversityDepartment of Physiotherapy, Podiatry and Prosthetics and OrthoticsMelbourneVictoriaAustralia3004
| | - Michael J Abramson
- Monash UniversitySchool of Public Health & Preventive MedicineMelbourneVictoriaAustralia3004
| | - Anne E Holland
- La Trobe UniversityDepartment of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and SportMelbourneVictoriaAustralia
- Institute for Breathing and SleepMelbourneAustralia
- Alfred HealthPhysiotherapyPO Box 315MelbourneAustraliaPrahran VIC 3181
- Monash UniversityDepartment of Allergy, Clinical Immunology and Respiratory MedicineMelbourneAustralia
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23
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Hansen H, Bieler T, Beyer N, Kallemose T, Wilcke JT, Østergaard LM, Frost Andeassen H, Martinez G, Lavesen M, Frølich A, Godtfredsen NS. Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial. Thorax 2020; 75:413-421. [PMID: 32229541 PMCID: PMC7231436 DOI: 10.1136/thoraxjnl-2019-214246] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/14/2020] [Accepted: 03/03/2020] [Indexed: 01/24/2023]
Abstract
RATIONALE Pulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR). OBJECTIVE To investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV1 <50% eligible for routine hospital-based, outpatient PR. METHODS In this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks' follow-up from baseline. The primary analysis was based on the intention-to-treat principle. MEASUREMENTS AND MAIN RESULTS The primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV1 33%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: -6.6 to 24.9)) or at 22 weeks' follow-up (-5.3 metres (95% CI: -28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ2 test p<0.01). CONCLUSION PTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design. Trial registration number ClinicalTrials.gov (NCT02667171), 28 January 2016.
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Affiliation(s)
- Henrik Hansen
- Respiratory Research Unit, Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
| | - Theresa Bieler
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, Copenhagen, Denmark
| | - Nina Beyer
- Institute for Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Thomas Kallemose
- Clinical Research Center, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Jon Torgny Wilcke
- Department of Pulmonary Medicine, Gentofte Hospital, Hellerup, Denmark
| | | | | | - Gerd Martinez
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
| | - Marie Lavesen
- Department of Respiratory Medicine and Infectious Diseases, Hillerød Hospital, Hillerød, Denmark
| | - Anne Frølich
- Department of Public Health, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
| | - Nina Skavlan Godtfredsen
- Institute for Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark.,Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
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Moore P, Atkins GT, Cramb S, Croft JB, Davis L, Dolor RJ, Doyle D, Elehwany M, James C, Knudson A, Linnell J, Mannino D, Rommes JM, Sood A, Stockton E, Weissman DN, Witte M, Wyatt E, Yarbrough WC, Yawn BP, Johnson L, Morris T, Kiley JP, Ammary-Risch NJ, Punturieri A. COPD and Rural Health: A Dialogue on the National Action Plan. J Rural Health 2019; 35:424-428. [PMID: 30677167 PMCID: PMC6790602 DOI: 10.1111/jrh.12346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Paul Moore
- Federal Office of Rural Health Policy, Health Resources and Services Administration, Rockville, Maryland
| | - Graham T Atkins
- Dartmouth-Hitchcock Medical Center and the Geisel School of Medicine, Lebanon, New Hampshire
| | | | - Janet B Croft
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa Davis
- Pennsylvania Office of Rural Health, University Park, Pennsylvania
| | - Rowena J Dolor
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Daniel Doyle
- Department of Family Medicine, West Virginia University, Morgantown, West Virginia
| | | | - Cara James
- Office of Minority Health, Centers for Medicare and Medicaid Services, Baltimore, Maryland
| | - Alana Knudson
- Walsh Center for Rural Health Analysis, University of Chicago, Chicago, Illinois
| | - John Linnell
- US COPD Coalition/Board of Directors, Washington, DC
| | | | | | - Akshay Sood
- Division of Pulmonary Critical Care and Sleep Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | | | - David N Weissman
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Mike Witte
- California Primary Care Association, Sacramento, California
| | | | | | | | - Lenora Johnson
- Office of Science Policy Engagement Education and Communications, National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, Maryland
| | - Tom Morris
- Federal Office of Rural Health Policy, Health Resources and Services Administration, Rockville, Maryland
| | - James P Kiley
- Division of Lung Diseases, National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, Maryland
| | - Neyal J Ammary-Risch
- Office of Science Policy Engagement Education and Communications, National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, Maryland
| | - Antonello Punturieri
- Division of Lung Diseases, National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, Maryland
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Hansen H, Beyer N, Frølich A, Godtfredsen N, Bieler T. Intra- and inter-rater reproducibility of the 6-minute walk test and the 30-second sit-to-stand test in patients with severe and very severe COPD. Int J Chron Obstruct Pulmon Dis 2018; 13:3447-3457. [PMID: 30425474 PMCID: PMC6203115 DOI: 10.2147/copd.s174248] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background In patients with COPD, the 6-minute walk test (6MWT) and the 30-second sit-to-stand test (30sec-STS) are widely used as clinical outcome measures of walking capacity, lower limb muscle strength, and functional ability. Due to a documented learning effect, at least two trials are recommended for assessment. The aim of our study was to investigate the intra- and inter-rater reliability and agreement of the two tests in patients with severe and very severe COPD (FEV1 <50%). Patients and methods Fifty patients (22 females; mean [SD]: age 67 [9] years, FEV1 predicted 32 [9]%) were assessed with the 6MWT and the 30sec-STS twice by the same assessor on test-day 1 (T1) and by another assessor 7–10 days later on test-day 2 (T2). Results The 6MWT intra- and inter-rater reliability (intraclass correlation coefficient, ICC1.1) was 0.98 (lower limit 95% CI: 0.94) and 0.96 (lower limit 95% CI: 0.94), respectively, and agreement (standard error of the measurement, SEM) was 14.8 and 20.5 m, respectively. The 30sec-STS intra- and inter-rater reliability and agreement results were, respectively, ICC1.1 0.94 (lower limit 95% CI: 0.90) and 0.92 (lower limit 95% CI: 0.86), with SEM of 0.97 and 1.14 repetitions. There was no difference (95% CI: −5.3; 8.1) between the 6MWT distances on T1, while the mean walking distance improved 7.9 m (0.0 m; 15.8 m) from T1 to T2. Improvement on the same test date was less likely (OR: 3.6 [95% CI: 1.1; 11.8], Fisher’s exact test, P=0.047) in patients who walked less than 350 m in the 6MWT. We found no clinically relevant learning effect in the 30sec-STS. Conclusion In patients with severe and very severe COPD the 6MWT and the 30sec-STS showed excellent intra- and inter-rater reliability and acceptable agreement. No learning effect was documented for the tests when performed on the same day. Our data suggest that in clinical practice using different assessors is acceptable, and that a single test trial may be sufficient to assess patients with severe and very severe COPD.
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Affiliation(s)
- Henrik Hansen
- Research Unit of Chronic Diseases and Telemedicine - Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark,
| | - Nina Beyer
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Frølich
- Research Unit of Chronic Diseases and Telemedicine - Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark,
| | - Nina Godtfredsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Respiratory Medicine, Hvidovre University Hospital, Hvidovre, Denmark
| | - Theresa Bieler
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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26
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Afzelius P, Molsted S, Tarnow L. Intermittent vacuum treatment with VacuMed does not improve peripheral artery disease or walking capacity in patients with intermittent claudication. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:456-463. [DOI: 10.1080/00365513.2018.1497803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Pia Afzelius
- Department of Diagnostic Imaging, Section of Clinical Physiology and Nuclear Medicine, Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Lise Tarnow
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
- Steno Diabetes Center, Zealand, Denmark
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