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Saynor ZL, Gruet M, McNarry MA, Button B, Morrison L, Wagner M, Sawyer A, Hebestreit H, Radtke T, Urquhart DS. Guidance and standard operating procedures for functional exercise testing in cystic fibrosis. Eur Respir Rev 2023; 32:230029. [PMID: 37558263 PMCID: PMC10410399 DOI: 10.1183/16000617.0029-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/31/2023] [Indexed: 08/11/2023] Open
Abstract
Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated.
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Affiliation(s)
- Zoe L Saynor
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Wessex Cystic Fibrosis Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Mathieu Gruet
- Laboratory of the Impact of Physical Activity on Health (IAPS), University of Toulon, Toulon, France
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Brenda Button
- Department of Physiotherapy, Melbourne School of Health Science, University of Melbourne, Melbourne, Australia
- Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia
| | - Lisa Morrison
- West of Scotland Adult CF Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Marlies Wagner
- Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Abbey Sawyer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helge Hebestreit
- Paediatric Department, University Hospitals Würzburg, Würzburg, Germany
| | - Thomas Radtke
- Division of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Don S Urquhart
- Royal Hospital for Children and Young People, Edinburgh, UK
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
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Aagaard TV, Lindberg K, Brorson S, Madsen UR, Skou ST. A 12-Week Supervised Exercise Therapy Program for Patients with Diabetic Foot Ulcers: Program Development and Preliminary Feasibility. INT J LOW EXTR WOUND 2023:15347346221149786. [PMID: 36604981 DOI: 10.1177/15347346221149786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Exercise therapy helps improve glycaemic control and insulin sensitivity and may be relevant in treating patients with diabetic foot ulcers (DFUs). This study describes the development of a 12-week exercise therapy program for patients with DFUs and the preliminary feasibility of the program focusing on the program's inclusion, adherence, and safety. The development process is built on knowledge from a published systematic review on exercise for people with DFUs and a grounded theory study on the main concerns of people with DFUs regarding physical activity. The development involved doctors, wound care nurses, podiatrists, and feedback from patients and physical therapists using semi-structured interviews. The program was designed as a combination of aerobic and resistance training exercises. The aerobic exercise phase on the stationary bike of 30-minute duration was aimed at a moderate intensity. Resistance exercises were conducted with a 15-repetition maximum approach (four to five sets per trial) throughout the 12-week period. Three patients were included and received the exercise intervention. Except for recruitment and retention rates, acceptance levels were met for all other research progression criteria. Patients found the intervention relevant, wanted further guidance on continuing exercising, and would have liked the intervention closer to their home for example, a municipality setting. Although the exercise therapy program for patients with DFUs was developed in a thorough process with the inclusion of available evidence and the involvement of patients and other stakeholders conclusions on feasibility are limited due to the low recruitment rate. A reconsideration of the setting is needed in future exercise intervention studies.
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Affiliation(s)
- Thomas Vedste Aagaard
- Department of Physiotherapy and Occupational Therapy, 53163Holbaek Hospital, Holbaek, Denmark
- Department of Orthopaedic Surgery, 53163Holbaek Hospital, Holbaek, Denmark
- Department of Orthopaedic Surgery, Centre for Evidence-Based Orthopaedics, Zealand University Hospital, Koge, Denmark
| | - Kajsa Lindberg
- Health and Rehabilitation Centre Vanloese, Copenhagen Municipality, Copenhagen, Denmark
| | - Stig Brorson
- Department of Orthopaedic Surgery, Centre for Evidence-Based Orthopaedics, Zealand University Hospital, Koge, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Riis Madsen
- Department of Orthopaedic Surgery, 53163Holbaek Hospital, Holbaek, Denmark
- REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
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Lu YX, Clemente FM, Bezerra P, Crowley-McHattan ZJ, Cheng SC, Chien CH, Kuo CD, Chen YS. Quantification of Respiratory and Muscular Perceived Exertions as Perceived Measures of Internal Loads During Domestic and Overseas Training Camps in Elite Futsal Players. Front Psychol 2022; 12:751030. [PMID: 35153893 PMCID: PMC8833098 DOI: 10.3389/fpsyg.2021.751030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background The rating of perceived exertion (RPE) scales with respiratory and muscular illustrations are recognized as simple and practical methods to understand individual psychometric characteristics in breathing and muscle exertion during exercise. However, the implementation of respiratory and muscular RPE to quantify training load in futsal training camps has not been examined. This study investigates respiratory and muscular RPE relationships during domestic training camps (DTC) and overseas training camps (OTC) in an under 20 futsal national team. Methods Data collected from eleven field players were used for comparison in this study (age = 18.7 ± 0.7 years, height = 171.9 ± 6.1 cm, body weight = 64.2 ± 8.4 kg). All players reported Borg CR10 RPE (RPECR10) and 7-scales respiratory RPE (RPErespiration) and muscular RPE (RPEmuscle) (Dalhousie pictorial scales) after training sessions and matches. Additionally, total distance covered (TD) and training impulse (TRIMP) were used to quantify external and internal loads via the Polar Team Pro system. Paired-sample t-tests were used to compare the RPECR10, RPErespiration, RPEmuscle, TD, and TRIMP between DTC and OTC. Furthermore, linear regression was performed to determine the relationships among all RPE scales, TD, and TRIMP. Results The RPECR10 (p = 0.047), TD (p < 0.001), and TRIMP (p < 0.001) showed significant difference between DTC and OTC. Furthermore, linear regression analyses showed significant correlation between RPErespiration and RPEmuscle (DTC: r = 0.857, p = 0.006; OTC: r = 0.924, p < 0.001), RPECR10 and RPErespiration (DTC: r = 0.857, p = 0.001; OTC: r = 0.863, p = 0.001), and RPECR10 and RPEmuscle (DTC: r = 0.906, p < 0.001; OTC: r = 0.900, p < 0.001). Conclusion Pictorial RPErespiration or RPEmuscle can be used as an alternative to quantify perceived measures of internal loads during DTC and OTC in futsal players. Interpretation of perceived measures of training load and cardiac-related responses in association with external training loads during short-term training camps would be useful in further understanding the demands of futsal players’ experience in these circumstances.
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Affiliation(s)
- Yu-Xian Lu
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
| | - Filipe M. Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, Lisbon, Portugal
| | - Pedro Bezerra
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
| | - Zachary J. Crowley-McHattan
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Shih-Chung Cheng
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Chia-Hua Chien
- Exercise and Health Promotion Association, New Taipei City, Taiwan
| | - Cheng-Deng Kuo
- Department of Medical Research, Taipei Veterans General Hospital, Taipei City, Taiwan
- Department of Medicine, Taian Hospital, Taipei City, Taiwan
- Tanyu Research Laboratory, Taipei City, Taiwan
- *Correspondence: Cheng-Deng Kuo,
| | - Yung-Sheng Chen
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
- Exercise and Health Promotion Association, New Taipei City, Taiwan
- Tanyu Research Laboratory, Taipei City, Taiwan
- Yung-Sheng Chen,
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Morishita S, Tsubaki A, Hotta K, Inoue T, Qin W, Kojima S, Fu JB, Onishi H. Face Pain Scale and Borg Scale compared to physiological parameters during cardiopulmonary exercise testing. J Sports Med Phys Fitness 2020; 61:1464-1468. [PMID: 33269889 DOI: 10.23736/s0022-4707.20.11815-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to investigate the differences between the Face Pain and Borg Scales for rating of perceived exertion (RPE) during cardiopulmonary exercise testing (CPET) in healthy adults, and their relationships with work rate (watts), heart rate (HR), oxygen uptake (VO<inf>2</inf>), and minute ventilation (VE). METHODS In this prospective observational study, two experiments were conducted. In Experiment 1, 77 healthy adults were randomly assigned to either the group using the Face Pain Scale (19 men, 18 women) or using the Borg Scale (21 men, 19 women) for the RPE during CPET. In Experiment 2, 40 healthy adults (20 men, 20 women) used both the Face Pain and Borg Scales for the RPE during CPET. In both experiments, CPET was performed on ramp protocols with incremental increases in the work rate by 20 watts/minute. Their responses in terms of watts, HR, VO<inf>2</inf>, VE, and RPE (assessed using the Face Pain Scale or Borg Scale) were recorded each minute. RESULTS There were significant relationships between the two scales and all physiological variables during CPET in 74 out of the 77 participants in Experiment 1 and in all subjects in Experiment 2 (P<0.05). The correlation coefficient of the Face Pain Scale with respect to the physiological parameters was slightly lower than that of Borg Scale in both experiments (P<0.05). The Face Pain Scale had a significant correlation with the Borg Scale during CPET in Experiment 2 (P<0.05). CONCLUSIONS The Face Pain Scale may be useful for determining the intensity of exercise in healthy adults, similar to the Borg Scale.
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Affiliation(s)
- Shinichiro Morishita
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan -
| | - Atsuhiro Tsubaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazuki Hotta
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Tatsuro Inoue
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Weixiang Qin
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Jack B Fu
- Department of Palliative, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
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Najafi A, Ebrahim K, Ahmadizad S, Jahani Ghaeh Ghashlagh GR, Javidi M, Hackett D. Improvements in soccer-specific fitness and exercise tolerance following 8 weeks of inspiratory muscle training in adolescent males. J Sports Med Phys Fitness 2020; 59:1975-1984. [DOI: 10.23736/s0022-4707.19.09578-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Effects of Pursed Lip Breathing on Exercise Capacity and Dyspnea in Patients With Interstitial Lung Disease. J Cardiopulm Rehabil Prev 2019; 39:112-117. [DOI: 10.1097/hcr.0000000000000387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Psychometric Evaluation of the Chinese Respiratory Distress Observation Scale on Critically Ill Patients With Cardiopulmonary Diseases. J Nurs Res 2018; 26:340-347. [PMID: 29219939 DOI: 10.1097/jnr.0000000000000250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Respiratory distress is a common and distressing experience that strikes most critically ill patients with cardiopulmonary diseases. Now, most dyspnea assessment tools rely on patient's self-report. Only one instrument, the Respiratory Distress Observation Scale (RDOS), is valid for assessing respiratory distress when the patient cannot provide a dyspnea self-report. PURPOSE The aims of this study were to develop the Chinese version of RDOS through two-way translation and examine its reliability and validity. METHODS The first step was the translation and back-translation to establish the Chinese RDOS and examine the semantic equivalence between the back-translation version and the original one. The second step was the psychometric testing of the Chinese RDOS including internal reliability, interrater reliability, concurrent validity, convergent validity, and content and construct validity. RESULTS The Chinese RDOS was reported with an internal consistency (Cronbach's α value) of .73, an interobserver reliability of .97, and a content validity index of .97. In the conscious critically ill patients, significant correlations were found between the Chinese RDOS and Spielberger State Anxiety Inventory scores or Dyspnea Vertical Visual Analog Scale scores (r = .69 and r = .76, respectively; p < .001). In the unconscious critically ill patients, there was a significantly positive correlation between the Chinese RDOS scores and fraction of inspiration O2 (r = .26, p < .05) and a significantly negative correlation between the Chinese RDOS scores and saturation peripheral oxygen (SpO2; r = -.42, p = .001). In addition, it also could effectively identify the dyspnea differences between the first and last days in the intensive care units (p < .001). CONCLUSIONS The Chinese RDOS showed good reliability and validity in conscious critically ill patients. The assessment with the Chinese RDOS could be completed within a short period no matter whether the assessor has nursing background in respiratory care or not. It could help the professionals systematically manage and track the change of respiratory distress in patients.
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Causer AJ, Shute JK, Cummings MH, Shepherd AI, Bright V, Connett G, Allenby MI, Carroll MP, Daniels T, Saynor ZL. Cardiopulmonary exercise testing with supramaximal verification produces a safe and valid assessment of V̇o 2max in people with cystic fibrosis: a retrospective analysis. J Appl Physiol (1985) 2018; 125:1277-1283. [PMID: 30346240 DOI: 10.1152/japplphysiol.00454.2018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The validity and safety of using supramaximal verification (Smax) to confirm a maximal effort during cardiopulmonary exercise testing (CPET) in people with cystic fibrosis (CF) and/or those with severe disease has been questioned. Therefore, this study aimed to investigate these concerns in children, adolescents, and adults with mild-to-severe CF lung disease. Retrospective analysis of 17 pediatric and 28 adult participants with CF [age range: 9.2-62.9 y; forced expiratory volume in 1 s: 66.7% (range: 29.9%-102.3%); 30 men] who completed a routine ramp-incremental cycling test to determine peak oxygen uptake (V̇o2peak) was studied. Maximal oxygen uptake (V̇o2max) was subsequently confirmed by Smax at 110% of peak power output. All participants satisfied the criteria to verify a maximal effort during CPET. However, Smax-V̇o2peak exceeded ramp-V̇o2peak in 3/14 (21.4%) of pediatric and 6/28 (21.4%) adult exercise tests. A valid measurement of V̇o2max was attained in 85.7% of pediatric and 96.4% of adult exercise tests, as Smax-V̇o2peak did not exceed ramp-V̇o2peak by >9%. Adults ( n = 9) experienced a ≥5% reduction in arterial O2 saturation during CPET, 4 during both the ramp and Smax, 3 during only the ramp, and 2 during only Smax. Smax did not significantly worsen perceived breathing effort, chest tightness, throat narrowing, or exertion compared with ramp-incremental testing. Given the clinical importance of aerobic fitness in people with CF, incorporating Smax is recommended to provide a safe and valid measure of V̇o2max in children, adolescents, and adults who span the spectrum of CF disease severity. NEW & NOTEWORTHY Incorporating supramaximal verification into cardiopulmonary exercise testing protocols did not increase the frequency of adverse events or perceived discomfort versus a single-phase incremental exercise test in people with mild-to-severe cystic fibrosis. Furthermore, a valid measure of maximal oxygen uptake (V̇o2max) was obtained from 85.7% of pediatric and 96.4% of adult exercise tests, whereas peak oxygen uptake underestimated aerobic fitness in comparison with V̇o2max in 21.4% of cases (by up to 24.4%).
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Affiliation(s)
- Adam J Causer
- Department of Sport and Exercise Science, Faculty of Science, University of Portsmouth , Portsmouth , United Kingdom.,Cystic Fibrosis Unit, University Hospital Southampton National Health Service Foundation Trust , Southampton , United Kingdom
| | - Janis K Shute
- School of Pharmacy and Biomedical Sciences, Faculty of Science, University of Portsmouth , Portsmouth , United Kingdom
| | - Michael H Cummings
- Department of Diabetes and Endocrinology, Queen Alexandra Hospital , Portsmouth , United Kingdom
| | - Anthony I Shepherd
- Department of Sport and Exercise Science, Faculty of Science, University of Portsmouth , Portsmouth , United Kingdom
| | - Victoria Bright
- Cystic Fibrosis Unit, University Hospital Southampton National Health Service Foundation Trust , Southampton , United Kingdom
| | - Gary Connett
- National Institute for Health Research, Southampton Biomedical Research Centre, Southampton Children's Hospital , United Kingdom
| | - Mark I Allenby
- Cystic Fibrosis Unit, University Hospital Southampton National Health Service Foundation Trust , Southampton , United Kingdom
| | - Mary P Carroll
- Cystic Fibrosis Unit, University Hospital Southampton National Health Service Foundation Trust , Southampton , United Kingdom
| | - Thomas Daniels
- Cystic Fibrosis Unit, University Hospital Southampton National Health Service Foundation Trust , Southampton , United Kingdom
| | - Zoe L Saynor
- Department of Sport and Exercise Science, Faculty of Science, University of Portsmouth , Portsmouth , United Kingdom.,Cystic Fibrosis Unit, University Hospital Southampton National Health Service Foundation Trust , Southampton , United Kingdom
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Navas A, Artigues C, Leiva A, Portells E, Soler A, Cladera A, Ortas S, Alomar M, Gual M, Manzanares C, Brunet M, Julià M, López L, Granda L, Bennasar-Veny M, Carrascosa MC. Effectiveness and safety of moderate-intensity aerobic water exercise during pregnancy for reducing use of epidural analgesia during labor: protocol for a randomized clinical trial. BMC Pregnancy Childbirth 2018; 18:94. [PMID: 29642862 PMCID: PMC5896064 DOI: 10.1186/s12884-018-1715-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/23/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Epidural analgesia during labor can provide effective pain relief, but can also lead to adverse effects. The practice of moderate exercise during pregnancy is associated with an increased level of endorphins in the blood, and this could also provide pain relief during labor. Aerobic water exercises, rather than other forms of exercise, do not negatively impact articulations, reduce edema, blood pressure, and back pain, and increase diuresis. We propose a randomized controlled trial (RCT) to evaluate the effectiveness and safety of a moderate water exercise program during pregnancy on the need for epidural analgesia during labor. METHODS A multi-center, parallel, randomized, evaluator blinded, controlled trial in a primary care setting. We will randomised 320 pregnant women (14 to 20 weeks gestation) who have low risk of complications to a moderate water exercise program or usual care. DISCUSSION The findings of this research will contribute toward understanding of the effects of a physical exercise program on pain and the need for analgesia during labor. TRIAL REGISTRATION ISRCTN Registry identifier: 14097513 register on 04 September 2017. Retrospectively registered.
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Affiliation(s)
- Araceli Navas
- Baleares Health Services-IbSalut, Hospital de Son Espases, 07005 Palma, Spain
| | - Catalina Artigues
- Pont D’Inca- Marratxí Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca. Baleares Health Services-IbSalut, 07005 Palma, Spain
- Instituto de Investigación Sanitaria de Palma(IdISPa), 07010 Palma, Spain
| | - Elena Portells
- Muntanya- Marratxí Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Aina Soler
- Primary Care Research Unit of Mallorca. Baleares Health Services-IbSalut, 07005 Palma, Spain
- Instituto de Investigación Sanitaria de Palma(IdISPa), 07010 Palma, Spain
| | - Antonia Cladera
- Santa María Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Silvia Ortas
- S’Excorxador Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Margarita Alomar
- Can Pastilla Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Marina Gual
- Soller Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | | | - Marina Brunet
- Santa Ponça Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Magdalena Julià
- Alcudia Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Lidia López
- Baleares Health Services-IbSalut, Hospital Comarcal de Inca, 07005 Palma, Spain
| | - Lorena Granda
- Baleares Health Services-IbSalut, Hospital de Manacor, 07005 Palma, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Research Group on Evidence, Lifestyles & Health, University of the Balearic Islands, 07122 Palma, Spain
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Tian C, Wang JY, Wang ML, Jiang B, Zhang LL, Liu F. Morphine versus methylprednisolone or aminophylline for relieving dyspnea in patients with advanced cancer in China: a retrospective study. SPRINGERPLUS 2016; 5:1945. [PMID: 27917339 PMCID: PMC5102996 DOI: 10.1186/s40064-016-3651-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022]
Abstract
Context Dyspnea is one of the most common and distressing symptoms that occurs in terminal cancer patients. However, there are no existing treatment guidelines for this condition in China. Objective This single-center, retrospective, observational study aimed to compare the efficacy of using morphine, methylprednisolone, or aminophylline to relieve the symptom of breathlessness in patients with advanced malignant tumors and to investigate the safety of these regimens during the treatment of dyspnea. Methods Between August 2011 and January 2015 we retrospectively reviewed the medical records of 343 terminally ill cancer patients with dyspnea who received morphine, methylprednisolone, or aminophylline. The therapeutic effect of each treatment by means of visual analogue scale (VAS) scores was assessed and compared. Statistical methods included Chi square and analysis of variance tests. Differences were considered significant when P < 0.05. Results VAS scores after treatment were (16.82 ± 10.89), (25.72 ± 15.03), and (31.95 ± 16.00) points in the morphine, methylprednisolone, and aminophylline group, respectively. These differences were found to be significantly different (P < 0.05). The effectiveness ratings were 86.44, 62.16, and 49.12%, respectively (P < 0.05). Conclusions We found that morphine subcutaneous injection for advanced cancer patients with dyspnea was safe and typically more effective than methylprednisolone or aminophylline. Therefore, morphine treatment could significantly improve the quality of life in terminal cancer patients with short life expectancies who are experiencing shortness of breath.
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Affiliation(s)
- Cong Tian
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Jiong-Yi Wang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Mei-Ling Wang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Bin Jiang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Lu-Lu Zhang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Feng Liu
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
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