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Bamonti PM, Rose GA, Park S, Silberbogen AK, Moye J, Moy ML. Emotional Distress and Physical Activity Engagement in U.S. Veterans With Chronic Obstructive Pulmonary Disease: A Qualitative Study. Ann Behav Med 2024; 58:539-551. [PMID: 38847496 DOI: 10.1093/abm/kaae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Physical activity is recommended as part of guideline-based care for managing chronic obstructive pulmonary disease (COPD) at all stages of the disease. However, physical activity interventions are less effective in individuals with co-occurring emotional distress (i.e., depression and/or anxiety symptoms). Interventions that dually promote improved physical and mental health in COPD are needed. The first step for intervention development is understanding individuals' experience of these factors. PURPOSE To understand the experience of emotional distress in U.S. Veterans diagnosed with COPD and to explore how emotional distress impacts physical activity engagement. METHODS Structured interviews informed by the cognitive and behavioral models of psychopathology were conducted with 29 United States Veterans with COPD (89.66% male, age 67.72 ± 6.55 years, 93.10% White) at the VA Boston Healthcare System. Interviews were audio recorded, transcribed, and underwent thematic analysis. RESULTS Three major themes encapsulating 17 codes emerged through thematic analysis: (i) the experience of emotional distress in Veterans with COPD; (ii) the complex relationship between emotional distress, physical activity engagement, and COPD; (iii) contextual and personal factors. CONCLUSIONS Veterans' interpretation of their COPD symptoms as unpredictable and uncontrollable and COPD-related physical limitations influenced their experience of emotional distress, while the experience of emotional distress both promoted and deterred physical activity engagement. Veterans were motivated to engage in physical activity despite experiencing emotional distress when they faced a responsibility in daily life. They identified motivational strategies and self-regulation techniques to manage emotional distress and to foster physical activity.
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Affiliation(s)
- Patricia M Bamonti
- Research & Development Service, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Havard Medical School, Boston, MA, USA
| | - Grace A Rose
- Research & Development Service, VA Boston Healthcare System, Boston MA, USA
| | - Stella Park
- New England Geriatric Research Education & Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Amy K Silberbogen
- VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Jennifer Moye
- Department of Psychiatry, Havard Medical School, Boston, MA, USA
- New England Geriatric Research Education & Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Chen X, Hu S, Jia X, Zeng B. Incremental Load Respiratory Muscle Training Improves Respiratory Muscle Strength and Pulmonary Function in Children with Bronchiectasis. Can Respir J 2024; 2024:8884030. [PMID: 38818499 PMCID: PMC11139531 DOI: 10.1155/2024/8884030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 01/22/2024] [Accepted: 05/11/2024] [Indexed: 06/01/2024] Open
Abstract
Methods Participants underwent respiratory muscle training for 24 weeks. The main results were changes in respiratory muscle strength and pulmonary function indices (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow rate (PEF), forced expiratory flow 25-75% (FEF25-75%), and maximal midexpiratory flow 75/25 (MMEF75/25)) before, 12 weeks after, and 24 weeks after the intervention. The secondary outcomes were changes in the exercise load and work rate, exercise work, Leicester Cough Questionnaire (LCQ) scale, and Fatigue Severity Scale (FSS). Results Compared with before the intervention, after 24 weeks of respiratory muscle training, the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were significantly enhanced (P < 0.05), while FVC, FEV1, and PEF were significantly increased (P < 0.01). FEF25-75 and MMEF75/25 values showed significant improvement compared to those before training (P < 0.05). The exercise loading, work, and exercise work rate of expiratory muscle training were significantly improved compared to those before intervention (P < 0.05). The LCQ score increased significantly (P < 0.001), and the FSS score decreased significantly (P < 0.001). Conclusion Incremental load respiratory muscle training effectively improved children's lung function over the long term, improved the strength of their inspiratory and expiratory muscles, and improved their quality of life.
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Affiliation(s)
- Xiaolong Chen
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Shidong Hu
- Department of Pediatric Respiratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Xiaohui Jia
- Department of Pediatric Respiratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Bingbing Zeng
- Center of Traditional Chinese Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
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Topcuoğlu C, Sağlam M, Yağlı NV. Comparison of the effects of high and low-moderate load lower limb resistance training on muscle strength and exercise capacity in individuals with COPD: A systematic review and meta-analysis. Heart Lung 2024; 64:107-116. [PMID: 38128253 DOI: 10.1016/j.hrtlng.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/11/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Extrapulmonary changes also occur in COPD. Resistance training can increase muscle strength and exercise capacity. OBJECTIVE The objective of this systematic review was to examine and compare the effectiveness of high and low-moderate load lower limb resistance training on muscle strength and exercise capacity in individuals with stable chronic obstructive pulmonary disease (COPD). METHODS The PubMed/Medline, Scopus, Cochrane Library, ClinicalTrials.gov, Web of Science, EBSCO, and CINAHL databases were searched to identify the articles published in English between January 1970 and July 2023. RESULTS Seven randomized controlled trials with a total of 188 individuals with COPD (RT: 100, CG: 88) met the inclusion criteria. A significant difference was revealed (favoring high load) in the change in knee extensor muscle strength and leg press strength in the high load resistance training group compared to the low-moderate load resistance training group (MD 21.90 Nm, 95 % CI 17.46-26.34 Nm, p < 0.00001; MD 5.80 kg, 95 % CI 3.87-7.73 kg, p < 0.00001). A significant difference was observed in the change in 6 MWT (six minute walk test) distance (favoring low-moderate load) and VO2peak (peak oxygen uptake) (favoring high load) in the high load resistance training group compared to the low-moderate load resistance training group (MD -16.90 m, 95 % CI -29.76- -4.04 m, p < 0.010; MD 3.10 ml/kg/min, 95 % CI 2.65-3.55 ml/kg/min, p < 0.00001). CONCLUSION This systematic review and meta-analysis demonstrated that both high-load and low-moderate load resistance training increased muscle strength and might increase exercise capacity.
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Affiliation(s)
- Ceyhun Topcuoğlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Melda Sağlam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar Yağlı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Aprile I, Bramante L, La Russa C, Germanotta M, Barletta VT, Falchini F, Brambilla L, Guglielmelli E, Rossi P. A Multiaxial Rehabilitation Programme for Workers with COVID-19 Sequelae Using a Conventional and Technological-Robotic Approach: The Proposal of INAIL and Fondazione Don Carlo Gnocchi. Healthcare (Basel) 2023; 11:1593. [PMID: 37297733 PMCID: PMC10252900 DOI: 10.3390/healthcare11111593] [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: 03/07/2023] [Revised: 05/11/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
The COVID-19 sequelae have been shown to affect respiratory and cardiological functions as well as neuro-psychological functions, and, in some cases, metabolic/nutritional aspects. The Italian National Institute for Insurance against Accidents at Work (Istituto Nazionale Assicurazione Infortuni sul Lavoro, INAIL) recorded that, until December 2022, 315,055 workers were affected by COVID-19; therefore, there is a need to identify an effective approach to treat such patients. Robotic and technological devices could be integrated into the rehabilitation programme of people with long COVID conditions. A review of the literature showed that telerehabilitation may improve functional capacity, dyspnoea, performance, and quality of life in these patients, but no studies were found evaluating the effects of robot-mediated therapy or virtual reality systems. Considering the above, Fondazione Don Carlo Gnocchi and INAIL propose a multi-axial rehabilitation for workers with COVID-19 sequelae. To accomplish this goal, the two institutions merged the epidemiological information gathered by INAIL, the expertise in robotic and technological rehabilitation of Fondazione Don Carlo Gnocchi, and the literature review. Our proposal aims to facilitate a multi-axial rehabilitation approach customized to meet the unique needs of each individual, with a particular emphasis on utilizing advanced technologies to address the current and future challenges of patient care.
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Affiliation(s)
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Lucia Bramante
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
| | - Chiara La Russa
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
| | - Marco Germanotta
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | | | - Francesca Falchini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Lorenzo Brambilla
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Eugenio Guglielmelli
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy;
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy
| | - Patrizio Rossi
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
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Cheng SWM, McKeough ZJ, McNamara RJ, Alison JA. Pulmonary Rehabilitation Using Minimal Equipment for People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Phys Ther 2023; 103:pzad013. [PMID: 37140475 PMCID: PMC10158642 DOI: 10.1093/ptj/pzad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/10/2022] [Accepted: 12/28/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of pulmonary rehabilitation to a greater number of people with chronic obstructive pulmonary disease (COPD). The effectiveness of minimal equipment programs in people with COPD is unclear. This systematic review and meta-analysis aimed to determine the effects of pulmonary rehabilitation using minimal equipment for aerobic and/or resistance training in people with COPD. METHODS Literature databases were searched up to September 2022 for randomized controlled trials (RCTs) comparing the effect of minimal equipment programs with usual care or with exercise equipment-based programs for exercise capacity, health-related quality of life (HRQoL), and strength. RESULTS Nineteen RCTs were included in the review and 14 RCTs were included in the meta-analyses, which reported low to moderate certainty of evidence. Compared with usual care, minimal equipment programs increased 6-minute walk distance (6MWD) by 85 m (95% CI = 37 to 132 m). No difference in 6MWD was observed between minimal equipment and exercise equipment-based programs (14 m, 95% CI = -27 to 56 m). Minimal equipment programs were more effective than usual care for improving HRQoL (standardized mean difference = 0.99, 95% CI = 0.31 to 1.67) and were not different from exercise equipment-based programs for improving upper limb strength (6 N, 95% CI = -2 to 13 N) or lower limb strength (20 N, 95% CI = -30 to 71 N). CONCLUSION In people with COPD, pulmonary rehabilitation programs using minimal equipment elicit clinically significant improvements in 6MWD and HRQoL and are comparable with exercise equipment-based programs for improving 6MWD and strength. IMPACT Pulmonary rehabilitation programs using minimal equipment may be a suitable alternative in settings where access to gymnasium equipment is limited. Delivery of pulmonary rehabilitation programs using minimal equipment may improve access to pulmonary rehabilitation worldwide, particularly in rural and remote areas and in developing countries.
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Affiliation(s)
- Sonia Wing Mei Cheng
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zoe J McKeough
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Renae J McNamara
- Department of Physiotherapy, Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, Australia
- Woolcock Emphysema Centre, Woolcock Institute of Medical Research, Sydney, Australia
| | - Jennifer A Alison
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia
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Peres Costa I, Silva SM, Alves da Silva G, Dal Corso S, Stirbulov R, Ferrari Correa JC, Malosá Sampaio LM. Shuttle walk test categorization according to the qualifiers of the International Classification of Functioning, Disability, and Health: proposal for use in patients with difficult-to-treat asthma, a cross-sectional study. Physiother Theory Pract 2022:1-8. [PMID: 35414340 DOI: 10.1080/09593985.2022.2063212] [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: 10/18/2022]
Abstract
AIM To classify functional capacity of people with difficult-to-treat asthma based on the International Classification of Functioning, Disability and Health (ICF). METHODS Fifty-seven patients underwent the Incremental Shuttle Walk Test (ISWT) to assess functional capacity, in order to categorize them functionally we used the ICF qualifiers. To qualify ISWT results the individual's impairment (i.e. percentage of distance walked in relation to the percentage of predicted) was analyzed. Additionally, body mass index (BMI); physical activity level (IPAQ); and pulmonary function were evaluated. In order to analyze the difference between functional capacity levels, two groups were compared (i.e. mild/moderate vs. severe impairment); therefore, the participants were matched according to age and BMI and the unpaired Student t test was used. RESULTS Among the fifty-seven included individuals, only one (1.8%) presented mild functional capacity limitation, 12 (21.1%) moderate limitation and 44 (77.2%) severe limitation. There was a significant difference between the ISWT distance between groups (F = 0.217, p < .001). The other variables did not present differences between the mild/moderate and severe groups. CONCLUSION The ICF qualifiers were able to categorize the ISWT and classified the functional capacity limitation as mild, moderate and severe. Therefore, it has proved to be a useful clinical tool for evaluation, follow-up and clinical decision-making.
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Affiliation(s)
- Ivan Peres Costa
- in Rehabilitation Sciences, Nove de Julho UniversityMaster's and Doctoral Programs , São Paulo, Brazil
| | - Soraia Micaela Silva
- in Rehabilitation Sciences, Nove de Julho UniversityMaster's and Doctoral Programs , São Paulo, Brazil
| | - Graziella Alves da Silva
- in Rehabilitation Sciences, Nove de Julho UniversityMaster's and Doctoral Programs , São Paulo, Brazil
| | - Simone Dal Corso
- in Rehabilitation Sciences, Nove de Julho UniversityMaster's and Doctoral Programs , São Paulo, Brazil
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Karagiannis C, Savva C, Korakakis V, Adamide T, Georgiou A, Matheou I, Prodromou A, Xanthos T. Effect of Strength Versus Strength and Endurance Upper Limb Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: A RANDOMIZED CLINICAL TRIAL. J Cardiopulm Rehabil Prev 2021; 41:426-431. [PMID: 34117184 DOI: 10.1097/hcr.0000000000000620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Pulmonary rehabilitation (PR) including exercise training improves muscle strength, exercise capacity, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). However, the evidence of the effect of upper limb exercise training (ULET) on activities of daily living (ADL) is sparse. This study investigated the effect of two different types of ULET on ADL in addition to standard PR. METHODS Patients were randomly assigned to a strength or a combined ULET group. Both groups exercised 2 d/wk for 12 wk. Outcome measures were handgrip strength and muscle strength of biceps and triceps muscles. Moreover, health-related quality of life was assessed through the COPD assessment test (CAT) and Saint George Respiratory Questionnaire. Ability to perform ADL was evaluated through an ADL simulation test. Dyspnea was evaluated by a modified Medical Research Council scale, whereas dyspnea and fatigue perception during strength and ADL tests were measured through a modified Borg scale. RESULTS Thirty-six patients with COPD (67.4 ± 5.3 yr) participated in the study. Significant improvements in upper limb strength and CAT were found within both groups. At the end of the study period, patients in the combined group improved time of the ADL test (P = .02) with reduced perception of fatigue (P = .03) compared with patients in the strength group. CONCLUSIONS In addition to standard PR of patients with COPD, the combined endurance and resistance ULET program improved ADL and muscle strength, whereas resistance training only increased strength.
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Affiliation(s)
- Christos Karagiannis
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus (Drs Karagiannis and Savva and Ms Matheou); Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar (Dr Korakakis); Respiratory Clinic, Nicosia General Hospital, Nicosia, Cyprus (Dr Adamide); Private Doctor, Nicosia, Cyprus (Dr Georgiou); Physiotherapy Department, Nicosia General Hospital, and Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus (Ms Prodromou); and School of Medicine, European University Cyprus, Nicosia, Cyprus (Dr Xanthos)
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Gianjoppe-Santos J, Barusso-Grüninger M, Pires Di Lorenzo VA. Effects of low and high resistance training intensities on clinical outcomes in patients with COPD - a randomized trial. Physiother Theory Pract 2021; 38:2471-2482. [PMID: 34016024 DOI: 10.1080/09593985.2021.1929616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM To compare the effects of two different intensities of combined resistance and aerobic training on physical-functional aspects and perceptual aspects of health status in patients with Chronic Obstructive Pulmonary Disease (COPD). DESIGN This was a randomized parallel group trial. METHODS Thirty-one patients were assessed regarding: symptoms (COPD Assessment Test - CAT), quality of life (Saint George's Respiratory Questionnaire - SGRQ); exercise capacity (six-minute walk test and constant-workload resistance test - CWRT); and muscle strength (one-repetition maximum test and isometric muscle strength for knee extensors - Kext and elbow flexors - EFlex). Patients were randomized in two groups to perform a combined training: 1) LL/HR = Low-load/high-repetition resistance training (n = 16; 68 ± 9.3 years; FEV1 = 50.0 ± 15.7%pred); and 2) HL/LR = High-load/low-repetition resistance training (n = 15; 70 ± 6.5 years; FEV1 = 46.8 ± 14.5%pred), and underwent 36 sessions. RESULTS Symptoms, quality of life and exercise capacity presented significant improvement (p < .05) in both groups. Both intensities of resistance training improved symptoms (∆CAT: LL/HR = -3.9; HL/LR = -2.8) and exercise capacity (∆ tolerance time in CWRT: LL/HR = +450.9s; HL/LR = +583.4s) above minimal clinically important difference value. Nevertheless, improvement in quality of life (∆SGRQ: LL/HR = -3.8; HL/LR = -10) and in isometric muscle strength (∆KExt: LL/HR = +15.8 N; HL/LR = +37.7 N and (∆EFlex: LL/HR = +9.5 N; HL/LR = +29.9 N) was observed only in the HL/LR group, which also presented a larger number of responders considering isometric muscle strength. CONCLUSION High-intensity resistance training in a combined training was more effective in ameliorating several aspects of patients with COPD, responding more and better to physical-functional aspects and perceptual aspects of health status.
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Affiliation(s)
- Júlia Gianjoppe-Santos
- Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Marina Barusso-Grüninger
- Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Valéria Amorim Pires Di Lorenzo
- Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Effectiveness of Non-Presential Individualized Exercise Training PrOgram(NIETO) in Lower Limb Physical Performance in Advanced COPD. J Clin Med 2021; 10:jcm10051010. [PMID: 33801347 PMCID: PMC7958336 DOI: 10.3390/jcm10051010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/21/2023] Open
Abstract
Muscle training, a component of pulmonary rehabilitation (PR), improves the physical performance of patients with chronic obstructive pulmonary disease (COPD). Despite the existing evidence, the traditional center-based PR model is applied to a small percentage of patients and presents numerous problems of accessibility, adherence, and costs. This study presents a home model of simple muscle training, non-presential, monitored by telephone and individualized, according to the severity of the COPD. In addition, to evaluate the results, simple tests associated with the physical performance of the lower limbs, previously validated in COPD, have been used, such as the four-meter walk, speed test (4MGS) and the five-repetition test sitting and standing (5STS). The objective was to evaluate whether the Individualized Non-Presential Exercise Training PrOgram (NIETO) induces improvements in the 4MGS, 5STS and quadriceps muscle strength (QMS) tests in outpatients with advanced COPD (FEV1 ≤ 50%). After one year, the QMS was significantly higher in the intervention group (IG) than in the control group (CG) (2.44 ± 4.07 vs. 0.05 ± 4.26 kg; p = 0.009). The 4MGS and 5STS tests were significantly shorter in IG than in CG (−0.39 ± 0.86 vs. 0.37 ± 0.96 s; p = 0.001) and (−1.55 ± 2.83 vs. 0.60 ± 2.06 s; p = 0.001), respectively. A home model of simple muscle training monitored by telephone such as NIETO, can improve 4MGS, 5STS, and quadriceps strength tests in outpatients with advanced COPD.
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Chushkin MI, Popova LA, Mandrykin SY, Kaprina NL. [Use of exercise tests and physical training in pulmonary rehabilitation]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2021; 98:64-70. [PMID: 33605132 DOI: 10.17116/kurort20219801164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of pulmonary rehabilitation reduces symptoms, improves life quality and exercise tolerance. The article presents indications for physical training, their characteristics and assessment of their effectiveness in the rehabilitation of patients with chronic lung diseases. It was noted that the execution of exercise tests (a monitoring with a progressive load increase on a bicycle ergometer or treadmill, a test with a constant load, a 6-minute walk test, a shuttle test with an increasing load and a shuttle test with a constant load) is appropriate for physical training before rehabilitation course. Physical endurance training programs are an essential component of pulmonary rehabilitation. Strength training, flexibility training and upper limb exercises give a good additional effect. To assess the effectiveness after rehabilitation programs, it is advisable to perform tests with physical activity. To assess the effectiveness of rehabilitation, the constant load exercise test and the constant load shuttle test are more sensitive to changes than the increasing load tests.
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Affiliation(s)
- M I Chushkin
- Central Research Institute of Tuberculosis, Moscow, Russia
| | - L A Popova
- Central Research Institute of Tuberculosis, Moscow, Russia
| | - S Yu Mandrykin
- Multidisciplinary Medical Center of the Bank of Russia, Moscow, Russia
| | - N L Kaprina
- Central Research Institute of Tuberculosis, Moscow, Russia
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Duan H, Li P, Wang Z, Chen H, Wang T, Wu W, Liu X. Effect of 12-week pulmonary rehabilitation on cognitive function in patients with stable chronic obstructive pulmonary disease: study protocol for a single-center randomised controlled trial. BMJ Open 2020; 10:e037307. [PMID: 33067278 PMCID: PMC7569932 DOI: 10.1136/bmjopen-2020-037307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/23/2020] [Accepted: 09/06/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Cognitive impairment, an important complication in patients with chronic obstructive pulmonary disease (COPD), seriously affects self-management of the disease and quality of life (QoL). As an exercise-based intervention programme, pulmonary rehabilitation (PR)-especially aerobic exercise (mainly mind-body exercise) and resistance exercise (RE)-has been proposed for its potential effectiveness in improving cognitive function. However, there is still a lack of strong evidence for PR's effectiveness. In this study, we expect to clarify the effects of pulmonary-based Qigong exercise and elastic band-based RE on cognitive function in patients with COPD and to fill in the relevant evidence blanks. METHODS AND ANALYSIS This study is a single-centre randomised controlled trial with assessor and data analyst blinding. We will recruit 108 participants with stable COPD starting on 23 December 2019, and randomly allocate them into the pulmonary-based Qigong exercise group, elastic band-based RE group, pulmonary-based Qigong exercise and elastic band-based RE combined group, or control group at a 1:1:1:1 ratio. Participants in intervention groups will perform 30 min of exercise two times per day, 5 days a week, for 12 weeks. The primary outcome will be the global cognitive function as assessed by the Montreal Cognitive Assessment and auditory event-related potential P300. Secondary outcomes will include the specific cognitive domains-attention, memory, executive function, verbal fluency and mental-processing speed; psychological functions and QoL. Exploratory outcomes will include grey matter volume and levels of inflammatory mediators. Outcomes will be measured before and after the interventions. ETHICS AND DISSEMINATION Ethics approval has been granted by the Ethics Committee of Yue-Yang Integrative Medicine Hospital, an affiliate of Shanghai University of Traditional Chinese Medicine, Shanghai, China (Grant No. 2019-141). Written informed consent will be obtained from each participant before any procedures are performed. The findings will be published in peer-reviewed journals and presented at academic conferences. TRIAL REGISTRATION NUMBER ChiCTR1900026869; pre-results.
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Affiliation(s)
- Hongxia Duan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peijun Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Zhenwei Wang
- Department of Respiratory Medicine, Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, China
| | - Haixia Chen
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Ting Wang
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Iwakura M, Okura K, Kubota M, Sugawara K, Kawagoshi A, Takahashi H, Shioya T. Estimation of minimal clinically important difference for quadriceps and inspiratory muscle strength in older outpatients with chronic obstructive pulmonary disease: a prospective cohort study. Phys Ther Res 2020; 24:35-42. [PMID: 33981526 DOI: 10.1298/ptr.e10049] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/17/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate the minimal clinically important difference (MCID) of quadriceps and inspiratory muscle strength after a home-based pulmonary rehabilitation program (PRP) in chronic obstructive pulmonary disease (COPD). METHOD Eighty-five COPD patients were included. Quadriceps maximal voluntary contraction (QMVC) was measured. We measured maximal inspiratory mouth pressure (PImax), the 6-minute walk distance (6MWD), the chronic respiratory questionnaire (CRQ) and the modified Medical Research Council dyspnoea score (mMRC). All measurements were conducted at baseline and at the end of the PRP. The MCID was calculated using anchor-based (using 6MWD, CRQ, and mMRC as possible anchor variables) and distribution-based (half standard deviation and 1.96 standard error of measurement) approaches. Changes in the five variables were compared in patients with and without changes in QMVC or PImax >MCID for each variable. RESULTS Sixty-nine COPD patients (age 75±6 years) were analysed. QMVC improved by 2.4 (95%CI 1.1-3.7) kgf, PImax by 5.8 (2.7-8.8) cmH2O, 6MWD by 21 (11-32) meters and CRQ by 3.9 (1.6-6.3) points. The MCID of QMVC and PImax was 3.3-7.5 kgf and 17.2-17.6 cmH2O, respectively. The MCID of QMVC (3.3 kgf) could differentiate individuals with significant improvement in 6MWD and PImax from those without. CONCLUSION The MCID of QMVC (3.3 kgf) can identify a meaningful change in quadriceps muscle strength after a PRP. The MCID of PImax (17.2 cmH2O) should be used with careful consideration, because the value is estimated using distributionbased method.
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Affiliation(s)
| | - Kazuki Okura
- Department of Rehabilitation, Akita University Hospital, Japan
| | - Mika Kubota
- Department of Rehabilitation, Akita City Hospital, Japan
| | - Keiyu Sugawara
- Department of Rehabilitation, Akita City Hospital, Japan
| | | | - Hitomi Takahashi
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Japan
| | - Takanobu Shioya
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Japan
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Cao A, Feng F, Zhang L, Zhou X. Baduanjin exercise for chronic obstructive pulmonary disease: an updated systematic review and meta-analysis. Clin Rehabil 2020; 34:1004-1013. [PMID: 32517512 DOI: 10.1177/0269215520926635] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To objectively evaluate the effectiveness of Baduanjin exercise on cardiopulmonary function and quality of life in chronic obstructive pulmonary disease patients. DATA SOURCES Articles published in PubMed, EMBASE, China National Knowledge Infrastructure Database, the Cochrane Library, Wanfang Database, and China Biological Medicine Database from inception to March 2020. REVIEW METHOD Articles on randomized controlled trials about Baduanjin exercise for the treatment of chronic obstructive pulmonary disease were identified. Cochrane handbook was applied to assess the quality of included trials. Stata (version 14.0) and Review Manager (version 5.3) were employed for data analysis. Mean difference with 95% confidence intervals were calculated for pulmonary function, 6-minute walking distance, and the quality of life. RESULTS Thirty-one randomized controlled trials including 3045 patients were included. The result of meta-analysis indicated that comparing with any other type of treatment alone, Baduanjin exercise combined other type of treatment revealed well efficacy in improving exercise capability on 6-minute walking distance (mean difference = 43.83, 95% confidence interval (29.47, 58.20), P < 0.00001), forced expiratory volume in 1 second (mean difference = 0.23, 95% confidence interval (0.15, 0.31), P < 0.00001), forced volume vital capacity (mean difference = 0.19, 95% confidence interval (0.08, 0.30), P = 0.0007), the ratio of forced expiratory volume in the first second to forced vital capacity (mean difference = 3.85, 95% confidence interval (2.19, 5.51), P < 0.00001), and the quality of life in chronic obstructive pulmonary disease patients regarding the St. George respiratory questionnaire (mean difference = -7.71, 95% confidence interval (-10.54, -4.89), P < 0.00001) and chronic obstructive pulmonary disease assessment test (mean difference = -2.56, 95% confidence interval (-4.13, -1.00), P = 0.001). CONCLUSIONS Baduanjin exercise could improve exercise capacity, pulmonary function, and quality of life for patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Ailing Cao
- Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Fanchao Feng
- Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Zhang
- Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xianmei Zhou
- Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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14
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Barlow R, Jones B, Rogerson M, Bannister H, Stuart R, Iqbal J, Andrews L, Easton I. An Evaluation of Service Provision and Novel Strength Assessment on Patient Outcomes in a UK-Based Pulmonary Rehabilitation Setting. COPD 2020; 17:280-288. [PMID: 32419522 DOI: 10.1080/15412555.2020.1764519] [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: 10/24/2022]
Abstract
This study's purpose was to (i) assess the impact of a 7-week pulmonary rehabilitation (PR) programme upon patient outcomes; incremental shuttle walk test (ISWT), COPD assessment tool (CAT), Clinical COPD Questionnaire (CCQ) and the Hospital Anxiety and Depression Scale (HADS); (ii) assess the impact of COPD severity on ISWT, psychological functioning and quality of life measures following PR; (iii) assess the feasibility of incorporating individually prescribed one repetition maximum (1RM) training loads into the existing strength training programme. Patients were people with COPD enrolled onto one of three versions (locations A, B and C) of a 7-week PR programme, which consisted of group exercise sessions and a social plus education element. Two locations incorporated individually prescribed training loads. Minimal clinically important changes (MCICs) are reported for the ISWT across all locations. Statistically significant changes in both CAT and the CCQ were found, with MCIC's evident for CAT score overall and individually at location B. MCIC's were not found for the CCQ. No statistically significant or MCICs were evident for the HADS. MCIC's were present only in patients with mild to moderate severity for the ISWT. For the CAT, moderate, severe and very severe patients with COPD experienced MCIC's. MCIC's and statistically significant increases in 1RM strength were seen at both locations. These findings evidence an effective PR service. Basic strength exercise programming and assessment are feasible and should be implemented in PR services to maximise patient outcomes.
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Affiliation(s)
| | - Ben Jones
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | - Mike Rogerson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | | | | | - Jawadh Iqbal
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Leanne Andrews
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Izzie Easton
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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15
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Maity S, Das M, Choudhury S, Faisal U. Assessment of cognitive function and hand dexterity in patients with chronic obstructive pulmonary disease: A cross-sectional study. J Nat Sci Biol Med 2020. [DOI: 10.4103/jnsbm.jnsbm_139_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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The Relevance of Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease. Clin Chest Med 2019; 40:367-383. [DOI: 10.1016/j.ccm.2019.02.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Kaszuba M, Śliwka A, Piliński R, Nowobilski R, Wloch T. Methodologies of inspiratory muscle training techniques in obstructive lung diseases. REHABILITACJA MEDYCZNA 2019. [DOI: 10.5604/01.3001.0013.1474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Inspiratory muscle training (IMT) is a non-pharmacological, non-invasive therapeutic method that can improve the quality of life in patients with obstructive lung diseases. The effectiveness of IMT may depends on the type of the device used in the training and the parameters of the training programme.
Objectives: The aim of the review was to present different techniques and protocols of IMT used in patients with obstructive lung diseases.
Methods: The MEDLINE and EMBASE were searched to identify the potentially eligible publications from the previous 5 years. The various protocols of IMT used in different studies were analysed and described in detail.
Results: A database search identified 333 records, of which 22 were included into the final analysis. All of the finally analysed studies were conducted in patients with chronic obstructive pulmonary disease (COPD). The protocols of IMT used in the studies differed in the type of the device used, the duration of the training programme, the number and the duration of training sessions, the initial load, and the rate at which the load was changed during the training.
Conclusions: IMT is used mainly in studies on patients with COPD and not with asthma. There is no one approved training programme for IMT. The most predominant type of IMT is a training with threshold loading. The most frequently used devices for IMT are POWERbreath and Threshold IMT. The protocols of IMT used in the studies are very diverse.
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Affiliation(s)
- Marek Kaszuba
- Zakład Rehabilitacji w Chorobach Wewnętrznych, Instytut Fizjoterapii, Wydział Nauk o Zdrowiu, Uniwersytet Jagielloński Collegium Medicum / Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Śliwka
- Zakład Rehabilitacji w Chorobach Wewnętrznych, Instytut Fizjoterapii, Wydział Nauk o Zdrowiu, Uniwersytet Jagielloński Collegium Medicum / Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Rafał Piliński
- Zakład Rehabilitacji w Chorobach Wewnętrznych, Instytut Fizjoterapii, Wydział Nauk o Zdrowiu, Uniwersytet Jagielloński Collegium Medicum / Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Roman Nowobilski
- Zakład Rehabilitacji w Chorobach Wewnętrznych, Instytut Fizjoterapii, Wydział Nauk o Zdrowiu, Uniwersytet Jagielloński Collegium Medicum / Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Wloch
- Zakład Rehabilitacji w Chorobach Wewnętrznych, Katedra Rehabilitacji Klinicznej, Wydział Rehabilitacji Ruchowej, Akademia Wychowania Fizycznego w Krakowie / Department of Physiotherapy, University School of Physical Education, Krakow, Poland
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18
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Westra B, de Wolf S, bij de Vaate E, Legemaat M, Nyberg A, Klijn P. Quality of resistance training description in COPD trials: study protocol for a systematic review. BMJ Open 2019; 9:e025030. [PMID: 30670522 PMCID: PMC6347903 DOI: 10.1136/bmjopen-2018-025030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Limb muscle dysfunction is a common manifestation in patients with chronic obstructive pulmonary disease (COPD). Optimising of limb muscle function is therefore an important goal during pulmonary rehabilitation of patients with COPD. Resistance training (RT) is the best available intervention to achieve this goal. Previous systematic reviews on RT primarily focused on methodological quality. However, the intervention holds the essence of each experimental study. Replication of RT interventions requires clear, complete and accessible reporting of the essential components. The American College of Sports Medicine (ACSM) provides evidence-based guidelines for RT prescription and recommends RT models specific to desired outcomes, that is, improvements in strength, muscular hypertrophy, power or local muscle endurance. The aim of this review is to investigate if the application of the RT principles and key training variables is described sufficiently in current evidence on the effects of RT interventions in patients with COPD. METHODS AND ANALYSIS Any research study (randomised, non-randomised controlled, controlled pre-post studies and observational studies) with an RT intervention in patients with COPD will be considered for this systematic review. Potentially relevant studies published in English from inception to 1 October 2017 will be identified from Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Physiotherapy Evidence Database (PEDro). Studies exploring the effects of RT following a single session and RT interventions limited to other respiratory chronic diseases will not be included. Additionally, studies including non-COPD participants will be excluded, if the COPD data are not separated. Pairs of reviewers will independently extract data using data collecting sheets. Quality appraisal of RT description will be performed in timeframes according to the latest published ACSM position statement on exercise or RT. ETHICS AND DISSEMINATION This protocol is a systematic review and therefore ethical approval is not required. The results of this review will be disseminated through peer-reviewed publication and presented at scientific conferences. PROSPERO REGISTRATION NUMBER CRD42017067403.
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Affiliation(s)
- Bennie Westra
- Department of Physiotherapy, Antonius Hospital, Sneek, The Netherlands
| | - Sander de Wolf
- Division of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Eline bij de Vaate
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
| | - Monique Legemaat
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
| | - André Nyberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Peter Klijn
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
- Department of Pulmonology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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19
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Costa IP, Politti F, Cahalin LP, de Carvalho EFT, Costa D, Corrêa JCF, Vieira RP, Oliveira-Junior MC, De Angelis K, Stirbulov R, Dal Corso S, de Carvalho PDT, Parizotto NA, Arena R, Sampaio LM. Acute Effects Using Light-Emitting Diode Therapy (LEDT) for Muscle Function during Isometric Exercise in Asthma Patients: A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7501870. [PMID: 30775383 PMCID: PMC6354134 DOI: 10.1155/2019/7501870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the effectiveness of acute application of LEDT in improving peripheral muscle performance during isometric exercise in patients with asthma. Eleven patients, with a mean age 38 ± 10, underwent a single LEDT and sham application in the femoral quadriceps' dominant member (cluster with 50 LED λ = 850 nm, 50 mW, 15 s; 37.5 J), 48 h apart in a randomized crossover design. Before and after LEDT and sham application, the patients were submitted an isometric endurance test (60% of the maximum isometric voluntary contraction), up to the limit of tolerance simultaneous recording of surface electromyography. There were no statistically significant differences between groups at the time of contraction (before 41±14 versus 44±16; after 46±12 versus 45±20 s) during the isometric contraction test and inflammatory markers before and after a single LEDT application. A single application of LEDT in the parameters and dose according to the equipment used in the study were not able to promote differences in the time of contraction and the fatigue response in asthmatic patients. However, the chronic effects of LEDT application for improving muscle performance in these patients are unknown and may present different responses during applications for a long time.
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Affiliation(s)
- Ivan Peres Costa
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Fabiano Politti
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | | | - Dirceu Costa
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - João Carlos Ferrari Corrêa
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Rodolfo P. Vieira
- Universidade Brasil, Post-Graduation Program in Bioengineering and Biomedical Engineering, São Paulo, Brazil
- Federal University of São Paulo (UNIFESP), Post-Graduation Program in Sciences in Human Movement and Rehabilitation, Santos, Brazil
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | | | - Kátia De Angelis
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | - Simone Dal Corso
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Paulo de Tarso de Carvalho
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Nivaldo Antonio Parizotto
- Department of Physiotherapy, Laboratory of Electrothermophototherapy, Federal University of São Carlos (UFSCAR), São Paulo, Brazil
- Post-Graduation Program in Biotechnology, University of Araraquara, Brazil
| | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois, Chicago, USA
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20
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McDonald VM, Osadnik CR, Gibson PG. Treatable traits in acute exacerbations of chronic airway diseases. Chron Respir Dis 2019; 16:1479973119867954. [PMID: 31409129 PMCID: PMC6696844 DOI: 10.1177/1479973119867954] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/09/2019] [Indexed: 01/06/2023] Open
Abstract
Acute exacerbations of chronic airway disease are common occurrences that cause a major burden of illness. Acute exacerbations are associated with impaired health status, increased lung function decline, hospitalization and increased risk of death. Exacerbation avoidance is a major priority. Despite this goal, exacerbations continue to occur and the need for effective models of care that optimize patient outcomes are urgently needed. 'Treatable Traits' is an approach to personalized medicine that has been proposed for the management of airway diseases. The treatable traits approach allows for the recognition of clinically important, identifiable and treatable disease characteristics, followed by targeted and individualized treatment interventions to address each trait. We review the literature relating to treatable traits in airway diseases; in particular, those traits that can predict exacerbations and approaches to management that aim to prevent exacerbations by using a treatable traits model of care. We propose this approach as a potentially useful model of care to both prevent and manage acute exacerbations.
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Affiliation(s)
- Vanessa M McDonald
- Priority Research Centre for Healthy Lungs and Centre of Excellence
in Severe Asthma, Faculty of Health and Medicine, University of Newcastle, New South
Wales, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital,
Newcastle, Australia
| | - Christian R Osadnik
- Department of Physiotherapy, Monash University, Melbourne,
Australia
- Monash Lung and Sleep, Monash Health, Melbourne, Australia
| | - Peter G Gibson
- Priority Research Centre for Healthy Lungs and Centre of Excellence
in Severe Asthma, Faculty of Health and Medicine, University of Newcastle, New South
Wales, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital,
Newcastle, Australia
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21
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ÖZEL A, TÜTÜN YÜMİN E, TUĞ T, SERTEL M. Effects of Quadriceps Muscle Strength and Kinesophobia On Health Related Quality of Life In Elderly Women and Men With Chronic Obstructive Pulmonary Disease. KONURALP TIP DERGISI 2018. [DOI: 10.18521/ktd.365860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Ozalp O, Inal‐Ince D, Cakmak A, Calik‐Kutukcu E, Saglam M, Savci S, Vardar‐Yagli N, Arikan H, Karakaya J, Coplu L. High‐intensity inspiratory muscle training in bronchiectasis: A randomized controlled trial. Respirology 2018; 24:246-253. [DOI: 10.1111/resp.13397] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/24/2018] [Accepted: 08/08/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Ozge Ozalp
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Deniz Inal‐Ince
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Aslihan Cakmak
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Ebru Calik‐Kutukcu
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Melda Saglam
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Sema Savci
- School of Physiotherapy and RehabilitationDokuz Eylül University Izmir Turkey
| | - Naciye Vardar‐Yagli
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Hülya Arikan
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationHacettepe University Ankara Turkey
| | - Jale Karakaya
- Faculty of Medicine, Department of BiostatisticsHacettepe University Ankara Turkey
| | - Lütfi Coplu
- Faculty of Medicine, Department of Chest MedicineHacettepe University Ankara Turkey
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Silva BSDA, Lira FS, Rossi FE, Ramos D, Uzeloto JS, Freire APCF, de Lima FF, Gobbo LA, Ramos EMC. Inflammatory and Metabolic Responses to Different Resistance Training on Chronic Obstructive Pulmonary Disease: A Randomized Control Trial. Front Physiol 2018; 9:262. [PMID: 29628896 PMCID: PMC5877487 DOI: 10.3389/fphys.2018.00262] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 03/07/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Low-grade inflammation can be present in chronic obstructive pulmonary disease (COPD), which may affect the regulation of muscle protein and body metabolism. Regular exercise show improvement in muscle strength and dyspnea in patients with COPD, however, the response to training on inflammatory and metabolic disorders is unclear. In this study, we compared the effects of resistance training using weight machines and elastic resistance (bands and tubes) on the inflammatory and metabolic responses in patients with COPD. Methods: Patients with COPD were randomized into three groups: elastic band group (EBG), elastic tube group (ETG), and weight machines equipment group (MG). EBG and ETG were analyzed together [elastic group (EG)]. The participants were evaluated for pulmonary function (spirometry), peripheral muscle strength (digital dynamometry), IL-6, TNF-α, IL-10, IL-15 (Immunoassay), glucose, triacylglycerol, total cholesterol, HDL-c, and albumin levels (Enzymatic colorimetric). Blood samples were collected to assess the acute and chronic exercise responses after 12 weeks of training protocol. Results: The patient's mean age was 71.53 ± 6.97 years old. FEV1 (percent predicted) was 50.69 ± 16.67 and 45.40 ± 15.15% for EG and MG, respectively (p = 0.28). All groups increased muscle strength (p < 0.05) with no differences between groups. The acute response to exercise after 12 weeks of training showed improvement of inflammation when compared to baseline. Regarding the chronic effects, it was observed a decrease of all cytokines, except IL-10 (p < 0.05). After 12 weeks of training, the analysis of the metabolic profile presented a reduction in glucose concentration (p < 0.01), with no differences between groups (p = 0.30) and a decrease in triacylglycerol for the EG (p > 0.01). Conclusions: Training with elastic resistances or conventional weight machines showed improvement of inflammation response after 12 weeks of training. Chronically, both training groups showed anti-inflammatory effects, with the EG showing a strong tendency to improve IL-10/TNF-α ratio and IL-10 levels. Trial registration : RBR-6V9SJJ.
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Affiliation(s)
- Bruna S de Alencar Silva
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Fábio S Lira
- Exercise and Immunometabolism Research Group, Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Fabrício E Rossi
- Immunometabolism of Skeletal Muscle and Exercise Research Group, Department of Physical Education, Federal University of Piaui, Teresina, Brazil
| | - Dionei Ramos
- Department of Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Juliana S Uzeloto
- Department of Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Ana P C F Freire
- Department of Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Fabiano F de Lima
- Department of Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Luís A Gobbo
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Ercy M C Ramos
- Department of Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
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Naseer BA, Al-Shenqiti AM, Ali AH, Al-Jeraisi TM, Gunjan GG, Awaidallah MF. Effect of a short term pulmonary rehabilitation programme on exercise capacity, pulmonary function and health related quality of life in patients with COPD. J Taibah Univ Med Sci 2017; 12:471-476. [PMID: 31435281 PMCID: PMC6694923 DOI: 10.1016/j.jtumed.2017.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 07/20/2017] [Accepted: 07/27/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Patients with chronic obstructive pulmonary disease (COPD) have been shown to benefit from pulmonary rehabilitation programmes. The purpose of this study was to ascertain the effects of a short-term pulmonary rehabilitation programme (PRP) on exercise capacity, pulmonary function and quality of life in patients with COPD. METHODS A pre-test and post-test experimental design was conducted on patients from the outpatient physical therapy department. Thirty stable COPD patients with mild to severe airflow obstruction, (mean age 54.1 ± 5.22, FEV1, between 0.80 and 0.30 predicted; FEV1/FVC < 0.70) were recruited for a 6-week comprehensive pulmonary rehabilitation programme (PRP) that included education and exercise training. Exclusion criteria included the following: cardiovascular conditions likely to be aggravated by exercise, locomotor impairment, haemoptysis, cognitive impairment, severe pulmonary hypertension, and metastatic cancer. The patients were randomly divided into experimental and control groups. RESULTS Six-minute walk distance (6MWD), pulmonary function (FEV1, FVC, FEV1/FVC), and St. George's Respiratory Questionnaire (SGRQ) scores were measured at baseline, at the end of the 3rd week and at the end of the 6th week. The results showed significant improvements in 6MWD and SGRQ (p < 0.05). CONCLUSION A 6-week outpatient-based PRP significantly improves exercise capacity and quality of life, irrespective of the degree of airflow obstruction.
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Affiliation(s)
- Bangi A. Naseer
- Faculty of Medical Rehabilitation Sciences, Taibah University, KSA
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Abstract
BACKGROUND People with chronic obstructive pulmonary disease (COPD) often experience difficulty with performing upper limb exercise due to dyspnoea and arm fatigue. Consequently, upper limb exercise training is typically incorporated in pulmonary rehabilitation programmes to improve upper limb exercise capacity; however, the effects of this training on dyspnoea and health-related quality of life (HRQoL) remain unclear. OBJECTIVES To determine the effects of upper limb training (endurance or resistance training, or both) on symptoms of dyspnoea and HRQoL in people with COPD. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register of trials, ClinicalTrials.gov and the World Health Organization trials portal from inception to 28 September 2016 as well as checking all reference lists of primary studies and review articles. SELECTION CRITERIA We included randomised controlled trials (RCTs) in which upper limb exercise training of at least four weeks' duration was performed. Three comparisons were structured as: a) upper limb training only versus no training or sham intervention; b) combined upper limb training and lower limb training versus lower limb training alone; and c) upper limb training versus another type of upper limb training. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted outcome data and assessed risk of bias. We contacted study authors to provide missing data. We determined the treatment effect from each study as the post-treatment scores. We were able to analyse data for all three planned comparisons. For the upper limb training only versus no training or sham intervention structure, the upper limb training was further classified as 'endurance training' or 'resistance training' to determine the impact of training modality. MAIN RESULTS Fifteen studies on 425 participants were included in the review, one of which was in abstract form only. Twelve studies were included in the meta-analysis across one or more of the three comparisons. The sample size of the included studies was small (12 to 43 participants) and overall study quality was moderate to low given the imprecision and risk of bias issues (i.e. missing information on sequence generation and allocation concealment as well as no blinding of outcome assessment and incomplete data).When upper limb training was compared to either no training or sham training, there was a small significant improvement in symptoms of dyspnoea with a mean difference (MD) of 0.37 points (95% confidence interval (CI) 0.02 to 0.72 points; data from four studies on 129 people). However, there was no significant improvement in dyspnoea when the studies of endurance training only (MD 0.41 points, 95% CI -0.13 to 0.95 points; data from two studies on 55 people) or resistance training only (MD 0.34 points, 95% CI -0.11 to 0.80 points; data from two studies on 74 people) were analysed. When upper limb training combined with lower limb training was compared to lower limb training alone, no significant difference in dyspnoea was shown (MD 0.36 points, 95% CI -0.04 to 0.76 points; data from three studies on 86 people). There were no studies which examined the effects on dyspnoea of upper limb training compared to another upper limb training intervention.There was no significant improvement in HRQoL when upper limb training was compared to either no training or sham training with a standardised mean difference (SMD) of 0.05 (95% CI -0.31 to 0.40; four studies on 126 people) or when upper limb training combined with lower limb training was compared to lower limb training alone (SMD 0.01, 95% CI -0.40 to 0.43; three studies on 95 people). Only one study, in which endurance upper limb training was compared to resistance upper limb training, reported on HRQoL and showed no between-group differences (St George's Respiratory Questionnaire MD 2.0 points, 95% CI -9 to 12; one study on 20 people).Positive findings were shown for the effects of upper limb training on the secondary outcome of unsupported endurance upper limb exercise capacity. When upper limb training was compared to either no training or sham training, there was a large significant improvement in unsupported endurance upper limb capacity (SMD 0.66, 95% CI 0.19 to 1.13; six studies on 142 people) which remained significant when the studies in this analysis of endurance training only were examined (SMD 0.99, 95% CI 0.32 to 1.66; four studies on 85 people) but not when the studies of resistance training only were examined (SMD 0.23, 95% CI -0.31 to 0.76; three studies on 57 people, P = 0.08 for test of subgroup differences). When upper limb training combined with lower limb training was compared to lower limb training alone, there was also a large significant improvement in unsupported endurance upper limb capacity (SMD 0.90, 95% CI 0.12 to 1.68; three studies on 87 people). A single study compared endurance upper limb training to resistance upper limb training with a significant improvement in the number of lifts performed in one minute favouring endurance upper limb training (MD 6.0 lifts, 95% CI 0.29 to 11.71 lifts; one study on 17 people).Available data were insufficient to examine the impact of disease severity on any outcome. AUTHORS' CONCLUSIONS Evidence from this review indicates that some form of upper limb exercise training when compared to no upper limb training or a sham intervention improves dyspnoea but not HRQoL in people with COPD. The limited number of studies comparing different upper limb training interventions precludes conclusions being made about the optimal upper limb training programme for people with COPD, although endurance upper limb training using unsupported upper limb exercises does have a large effect on unsupported endurance upper limb capacity. Future RCTs require larger participant numbers to compare the differences between endurance upper limb training, resistance upper limb training, and combining endurance and resistance upper limb training on patient-relevant outcomes such as dyspnoea, HRQoL and arm activity levels.
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Affiliation(s)
- Zoe J McKeough
- The University of SydneyDiscipline of Physiotherapy, Faculty of Health SciencesLidcombeAustralia
| | - Marcelo Velloso
- Universidade Federal de Minas Gerais (UFMG)Department of PhysiotherapyBelo HorizonteBrazil
| | - Vanessa P Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)Department of PhysiotherapyDiamantinaBrazil
| | - Jennifer A Alison
- The University of SydneyDiscipline of Physiotherapy, Faculty of Health SciencesLidcombeAustralia
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Nyberg A, Carvalho J, Bui KL, Saey D, Maltais F. Adaptations in limb muscle function following pulmonary rehabilitation in patients with COPD - a review. REVISTA PORTUGUESA DE PNEUMOLOGIA 2016; 22:342-350. [PMID: 27522458 DOI: 10.1016/j.rppnen.2016.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/31/2016] [Accepted: 06/18/2016] [Indexed: 06/06/2023] Open
Abstract
Even though chronic obstructive pulmonary disease (COPD) is primarily a disease of the respiratory system, limb muscle dysfunction characterized by muscle weakness, reduced muscle endurance and higher muscle fatigability, is a common secondary consequence and a major systemic manifestation of the disease. Muscle dysfunction is especially relevant in COPD because it is related to important clinical outcomes such as mortality, quality of life and exercise intolerance, independently of lung function impairment. Thus, improving muscle function is considered an important therapeutic goal in COPD management. Pulmonary rehabilitation (PR) is a multidisciplinary, evidence-based and comprehensive approach used to promote better self-management of the disease, minimize symptom burden, optimize functional status, and increase participation in activities of daily life. Exercise training, including cardiovascular and muscle exercises, is the cornerstone of PR and is considered the best available strategy to improve exercise tolerance and muscle function among patients with COPD. This paper addresses the various components of exercise training within PR used to improve limb muscle function in COPD, providing clinicians and health-care professionals with an overview and description of these various exercise modalities and of their effects on limb muscle function. Guidance and recommendations to help design optimal limb muscle training regimens for these patients are also presented.
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Affiliation(s)
- André Nyberg
- Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada.
| | - João Carvalho
- Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Kim-Ly Bui
- Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada; Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Didier Saey
- Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada; Faculté de médecine, Université Laval, Québec, QC, Canada
| | - François Maltais
- Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada; Faculté de médecine, Université Laval, Québec, QC, Canada
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Medina-Mirapeix F, Bernabeu-Mora R, Llamazares-Herrán E, Sánchez-Martínez MP, García-Vidal JA, Escolar-Reina P. Interobserver Reliability of Peripheral Muscle Strength Tests and Short Physical Performance Battery in Patients With Chronic Obstructive Pulmonary Disease: A Prospective Observational Study. Arch Phys Med Rehabil 2016; 97:2002-2005. [DOI: 10.1016/j.apmr.2016.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 04/30/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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O'Shea SD, Taylor NF, Paratz JD. Qualitative outcomes of progressive resistance exercise for people with COPD. Chron Respir Dis 2016; 4:135-42. [PMID: 17711912 DOI: 10.1177/1479972307075313] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The outcomes of quantitative investigations examining the effectiveness of exercise interventions for people with COPD are limited by the small number of measurement tools that can be included. In contrast, qualitative inquiry allows broader exploration of the perceived outcomes of an intervention. The purpose of this investigation is to explore the qualitative outcomes of a progressive resistance exercise (PRE) program for people with COPD. People with COPD, enrolled in a randomized controlled trial of PRE, were invited to participate in two semi-structured interviews conducted at the end (12 weeks) and 12 weeks after the training intervention (24 weeks). Interviews were audiotaped, transcribed and then coded independently by two researchers. Themes relating to training outcomes were then developed and described. Twenty-two participants were interviewed at 12 weeks, and 19 participants at 24 weeks. After PRE, participants reported a range of physical gains, particularly with regard to improved strength and reduced breathlessness during daily activities. Improved control and confidence during activities of daily living were important psychological benefits perceived by people with COPD, as was the social support experienced during group training sessions. At 24 weeks, confidence persisted despite a perceived plateau or dissipation of physical gains. People with COPD reported physical, psychological and social benefits after PRE, which had a positive effect on activity performance. Although the perceived physical benefits of training were not prominent at 24 weeks, feelings of increased confidence and control persisted. Chronic Respiratory Disease 2007 ;4: 135—142
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Affiliation(s)
- S D O'Shea
- School of Physiotherapy, La Trobe University, Melbourne, Australia.
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PESSINI J, BARBOSA AR, TRINDADE EBSDM. Chronic diseases, multimorbidity, and handgrip strength among older adults from Southern Brazil. REV NUTR 2016. [DOI: 10.1590/1678-98652016000100005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT Objective: To investigate the association between various chronic diseases, multimorbidity, and handgrip strength in community dwelling older adults in Southern Brazil. Methods: A cross-sectional study carried out with 477 older adults (60 years and older) who resided in Antônio Carlos, Santa Catarina state. Subjects aged 60-79 years were selected by probability sampling (n=343) and all subjects aged 80 years or older (n=134) were evaluated. Chronic diseases were identified by self-report. A mechanical dynamometer verified handgrip strength (i.e., the outcome). Adjustments variables were age, literacy, living arrangement, smoking, body mass index, cognitive function, and comorbid chronic diseases. Sex-stratified analyses were conducted with simple and multiple linear regression. Results: A total of 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years) were assessed. In the adjustment analysis, cancer (β=-3.69; 95%CI=-6.97 to -0.41) and depression (β=-1.65; 95%CI=-3.20 to -0.10) were associated with lower handgrip strength in women. For men, diabetes (β=-5.30; 95%CI=-9.64 to -0.95), chronic lung disease (β=-4.74; 95%CI=-7.98 to -1.50), and coronary heart disease (β=-3.07; 95%CI=-5.98 to -0.16) were associated with lower handgrip strength values. There was an inverse trend between number of diseases and handgrip strength for men only. Conclusion: The results showed an independent association between chronic diseases and handgrip strength. As such, handgrip strength is a valid measure to use for prevention or intervention in chronic disease and multimorbidity.
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Tasdemir F, Inal-Ince D, Ergun P, Kaymaz D, Demir N, Demirci E, Egesel N. Neuromuscular electrical stimulation as an adjunct to endurance and resistance training during pulmonary rehabilitation in stable chronic obstructive pulmonary disease. Expert Rev Respir Med 2015; 9:493-502. [DOI: 10.1586/17476348.2015.1068691] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Nyberg A, Saey D, Martin M, Maltais F. Muscular and functional effects of partitioning exercising muscle mass in patients with chronic obstructive pulmonary disease - a study protocol for a randomized controlled trial. Trials 2015; 16:194. [PMID: 25927288 PMCID: PMC4423627 DOI: 10.1186/s13063-015-0698-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low-load, high-repetitive single-limb resistance training may increase limb muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD) while minimizing the occurrence of limiting exertional symptoms. Whether high-repetitive single-limb resistance training would perform better than high-repetitive two-limb resistance training is unknown. In addition, the mechanisms underlying possible benefits of high-repetitive resistance training has not been investigated. The aims of this study are to compare single versus two-limb high-repetitive resistance training in patients with COPD and to investigate mechanisms of action of these training modalities. METHODS/DESIGN This trial is a prospective, assessor-blind, randomized controlled trial. The participants are patients with stable severe to very severe COPD who are older than 40 years of age and healthy controls. The intervention is single-limb, high-repetitive, resistance training with elastic bands, three times/week for 8 weeks. The control is two-limb high-repetitive resistance training with elastic bands, three times/week for 8 weeks. The primary outcomes is change in the 6-min walking distance after 8 weeks of single-limb or two-limb high-repetitive resistance training. The secondary outcomes are changes in limb muscle strength and endurance capacity, key protein involved in quadriceps anabolic/catabolic signalization, fiber-type distribution and capillarization, subjective dyspnea and muscle fatigue, muscle oxygenation, cardiorespiratory demand and health-related quality-of-life after 8 weeks of single-limb or two-limb high-repetitive resistance training. The acute effects of single-limb versus two-limb high-repetitive resistance training on contractile fatigue, exercise stimulus (the product of number of repetition and load), subjective dyspnea and muscle fatigue, muscle oxygenation, and cardiorespiratory demand during upper and lower limb exercises will also be investigated in patients with COPD and healthy controls. Randomization will be performed using a random number generator by a person independent of the recruitment process, using 1:1 allocation to the intervention and the control group using random block sizes. BLINDING All outcome assessors will be blinded to group assignment. DISCUSSION The results of this project will provide important information to help developing and implementing customized exercise training programs for patients with COPD. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02283580 Registration date: 4 November 2014. First participant randomized: 10 November 2014.
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Affiliation(s)
- Andrè Nyberg
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, 2725, chemin Sainte-Foy, Québec, G1V 4G5, Canada.
| | - Didier Saey
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, 2725, chemin Sainte-Foy, Québec, G1V 4G5, Canada. .,Département de réadaptation, Faculté de médecine, Université Laval, 1050, avenue de la Médecine, Québec, G1V 0A6, Canada.
| | - Mickaël Martin
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, 2725, chemin Sainte-Foy, Québec, G1V 4G5, Canada.
| | - François Maltais
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, 2725, chemin Sainte-Foy, Québec, G1V 4G5, Canada. .,Département de médecine, Faculté de médecine, Université Laval, 1050, avenue de la Médecine, Québec, G1V0A6, Canada.
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Rosenbek Minet L, Hansen LW, Pedersen CD, Titlestad IL, Christensen JK, Kidholm K, Rayce K, Bowes A, Møllegård L. Early telemedicine training and counselling after hospitalization in patients with severe chronic obstructive pulmonary disease: a feasibility study. BMC Med Inform Decis Mak 2015; 15:3. [PMID: 25886014 PMCID: PMC4336686 DOI: 10.1186/s12911-014-0124-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 12/12/2014] [Indexed: 11/27/2022] Open
Abstract
Background An essential element in the treatment of patients with chronic obstructive pulmonary disease (COPD) is rehabilitation, of which supervised training is an important part. However, not all individuals with severe COPD can participate in the rehabilitation provided by hospitals and municipal training centres due to distance to the training venues and transportation difficulties. The aim of the study was to assess the feasibility of an individualized home-based training and counselling programme via video conference to patients with severe COPD after hospitalization including assessment of safety, clinical outcomes, patients’ perceptions, organisational aspects and economic aspects. Methods The design was a pre- and post-test intervention study. Fifty patients with severe COPD were included. The telemedicine training and counselling included three weekly supervised exercise sessions by a physiotherapist and up to two supervised counselling and training sessions in energy conservation techniques by an occupational therapist. The telemedicine videoconferencing equipment was a computer containing a screen, a microphone, an on/off switch and a volume control. Results Thirty seven (74%) participants completed the programme, with improvements in health status assessed by the Clinical COPD Questionnaire and physical performance assessed by a sit-to-stand test and a timed-up-and-go test. There were no cases of patient fall or emergency contact with a general practitioner during the telemedicine training sessions. The study participants believed the telemedicine training and counselling was essential for getting started with being physically active in a secure manner. The business case showed that under the current financing system, the reimbursement to the hospital was slightly higher than the hospital expenditures. Thus, the business case for the hospital was positive. The organizational analysis indicated that the perceptions of the staff were that the telemedicine service had improved the continuity of the rehabilitation programme for the patients and enabled the patients’ everyday lives to be included in the treatment. Conclusions This study showed that home-based supervised training and counselling via video conference is safe and feasible and that telemedicine can help to ensure more equitable access to supervised training in patients with severe COPD. Trial registration Clinical Trials NCT02085187 (Date of registration 10.03.2014).
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Affiliation(s)
- Lisbeth Rosenbek Minet
- Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, JB Winsløws Vej 19, 5000, Odense C, Denmark. .,Department of Rehabilitation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Line Willads Hansen
- Department of Rehabilitation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Claus Duedal Pedersen
- Department of Clinical Innovation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Ingrid Louise Titlestad
- Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Jette Krøjgaard Christensen
- Department of Medicine, Odense University Hospital, Svendborg Hospital, Valdemarsgade 53, 5700, Svendborg, Denmark.
| | - Kristian Kidholm
- Department of Research and Health Technology Assessment, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Kathrine Rayce
- Department of Clinical Innovation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Alison Bowes
- School of Applied Science, University of Stirling, FK9 4LA, Stirling, Scotland, UK.
| | - Lilian Møllegård
- Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
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Soysal Tomruk M, Ozalevli S, Dizdar G, Narin S, Kilinc O. Determination of the relationship between cognitive function and hand dexterity in patients with chronic obstructive pulmonary disease (COPD): a cross-sectional study. Physiother Theory Pract 2015; 31:313-7. [DOI: 10.3109/09593985.2015.1004768] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Osadnik CR, Rodrigues FMM, Camillo CA, Loeckx M, Janssens W, Dooms C, Troosters T. Principles of rehabilitation and reactivation. ACTA ACUST UNITED AC 2015; 89:2-11. [PMID: 25591614 DOI: 10.1159/000370246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Skeletal muscle dysfunction and physical inactivity are two clinically important features of a wide range of acute and chronic respiratory conditions. Optimisation of both of these features is important in order to improve physical function, prevent clinical deterioration and maximise community participation. One of the most potent and evidence-based interventions to address these physical deficits is pulmonary rehabilitation (PR). Whilst the majority of PR research has been conducted in patients with chronic obstructive pulmonary disease, there is widespread recognition that PR can benefit many other respiratory patient groups. These include patients with interstitial lung diseases, asthma, pulmonary hypertension, pre-/post-lung surgery (e.g. lung cancer, transplantation) and cystic fibrosis to name a few. Exercise training must be appropriately prescribed by a skilled healthcare professional with comprehensive knowledge of the pathology and physiology of these conditions, as well as a sound understanding of the exercise physiology and core principles of exercise prescription, monitoring and progression. It has also become increasingly recognised that people with respiratory conditions, particularly those with chronic disease, are considerably less active than those of good health. PR should therefore aim to induce behavioural change to facilitate the adoption and maintenance of an active lifestyle. In addition, PR should pay attention to the psychological well-being of patients and self-management of their lung disease in all its aspects. To that end, multidisciplinary individualised programs should be offered. This review sets the scene of PR principles for a series of papers that will focus on specific diseases other than chronic obstructive pulmonary disease where rehabilitation may offer a clinically important aspect of care over and above conventional pharmacological treatment.
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Affiliation(s)
- Christian R Osadnik
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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Association between peripheral muscle strength and daily physical activity in patients with COPD: a systematic literature review and meta-analysis. J Cardiopulm Rehabil Prev 2014; 33:351-9. [PMID: 24142041 DOI: 10.1097/hcr.0000000000000022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease have skeletal muscle dysfunction and reduced daily physical activity (PA). Whether the reduction in quadriceps strength (QS) is directly linked to physical inactivity remains to be elucidated. METHODS A systematic review and a meta-analysis were conducted to determine the potential relationship between QS and the level of PA. The overall estimate of the correlation coefficient (r*) was calculated, and a subgroup analysis was conducted to analyze the association between QS and indices of PA separately. RESULTS A total of 8 studies were included in the meta-analysis. The overall association between QS and PA was low but highly significant (r * = 0.288, 95% CI = 0.180-0.389; P < .001). In the subgroup analysis, the association between QS and the number of steps per day was low (r = 0.260; 95% CI = 0.060-0.440) and the association between QS and the time spent walking was moderate (r = 0.418; 95% CI = 0.229-0.576). CONCLUSIONS Peripheral muscle strength is associated with PA as assessed by the number of steps per day and the time spent walking in patients with chronic obstructive pulmonary disease. The overall association between QS and PA was low to moderate and highly significant.
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Houchen-Wolloff L, Sandland CJ, Harrison SL, Menon MK, Morgan MD, Steiner MC, Singh SJ. Ventilatory requirements of quadriceps resistance training in people with COPD and healthy controls. Int J Chron Obstruct Pulmon Dis 2014; 9:589-95. [PMID: 24940055 PMCID: PMC4051516 DOI: 10.2147/copd.s59164] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background It is proposed that resistance training (RT) does not activate the cardiopulmonary system to the same extent as whole-body exercise. This is important for patients with chronic obstructive pulmonary disease (COPD) who are ventilatory limited. Objective The aim was to assess the ventilatory response to an isokinetic quadriceps RT program in people with COPD and healthy controls. Design Observational. Registration number ISRCTN22764439. Setting Outpatient, university teaching hospital. Participants and outcome measures People with COPD (n=14) and healthy controls (n=11) underwent breath-by-breath analysis of their ventilation during an RT session (five sets of 30 maximal knee extensions at 180°/sec). Subjects performed a maximal cycle ergometry test (CET) at baseline. Peak ventilation (VE; L/min) and oxygen consumption (VO2; mL/kg/min) were collected. The same system measured VO2 and VE during the RT session. Parameters are presented as a percentage of the maximal CET. Isokinetic workload, symptom scores, heart rate (HR), and oxygen saturation were documented post-training. Results People with COPD worked at higher percentages of their maximal capacity than controls (mean range between sets 1–5 for VO2 =49.1%–60.1% [COPD], 45.7%–51.43% [controls] and for VE =57.6%–72.2% [COPD], 49.8%–63.6% [controls]), although this was not statistically significant (P>0.1 in all cases). In absolute terms, the difference between groups was only significant for actual VO2 on set 2 (P<0.05). Controls performed more isokinetic work than patients with COPD (P<0.05). Median Borg symptom scores after RT were the same in both groups (3 breathlessness, 13 exertion), no de-saturation occurred, and both groups were training at ≥65% of their maximum HR. Conclusion No statistically significant differences were found between people with COPD and healthy controls for VO2 and VE achieved during training. The symptoms associated with training were within acceptable limits.
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Affiliation(s)
- Linzy Houchen-Wolloff
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Carolyn J Sandland
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Samantha L Harrison
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Manoj K Menon
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Mike D Morgan
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Michael C Steiner
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK ; Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Nyberg A, Lindström B, Rickenlund A, Wadell K. Low-load/high-repetition elastic band resistance training in patients with COPD: a randomized, controlled, multicenter trial. CLINICAL RESPIRATORY JOURNAL 2014; 9:278-88. [DOI: 10.1111/crj.12141] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/14/2014] [Accepted: 04/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Andre Nyberg
- Department of Community Medicine and Rehabilitation; Physiotherapy; Umeå University; Umeå Sweden
| | - Britta Lindström
- Department of Community Medicine and Rehabilitation; Physiotherapy; Umeå University; Umeå Sweden
| | - Anette Rickenlund
- Department of Clinical Physiology; Karolinska University Hospital; Stockholm Sweden
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation; Physiotherapy; Umeå University; Umeå Sweden
- Department of Public Health and Clinical Medicine; Division of Medicine; Umeå University; Umeå Sweden
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Early exercise rehabilitation of muscle weakness in acute respiratory failure patients. Exerc Sport Sci Rev 2014; 41:208-15. [PMID: 23873130 DOI: 10.1097/jes.0b013e3182a4e67c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Acute respiratory failure patients experience significant muscle weakness, which contributes to prolonged hospitalization and functional impairments after hospital discharge. Based on our previous work, we hypothesize that an exercise intervention initiated early in the intensive care unit aimed at improving skeletal muscle strength could decrease hospital stay and attenuate the deconditioning and skeletal muscle weakness experienced by these patients.
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Andrianopoulos V, Klijn P, Franssen FME, Spruit MA. Exercise training in pulmonary rehabilitation. Clin Chest Med 2014; 35:313-22. [PMID: 24874127 DOI: 10.1016/j.ccm.2014.02.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Exercise training remains a cornerstone of pulmonary rehabilitation (PR) in patients with chronic respiratory disease. The choice of type of exercise training depends on the physiologic requirements and goals of the individual patient as well as the available equipment at the PR center. Current evidence suggests that, at ground walking exercise training, Nordic walking exercise training, resistance training, water-based exercise training, tai chi, and nonlinear periodized exercise are all feasible and effective in (subgroups) of patients with chronic obstructive pulmonary disease. In turn, these exercise training modalities can be considered as part of a comprehensive, interdisciplinary PR program.
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Affiliation(s)
- Vasileios Andrianopoulos
- Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, Horn 6085 NM, The Netherlands.
| | - Peter Klijn
- Department of Pulmonology, Merem Asthma Center Heideheuvel, Soestdijkerstraatweg 129, 1213 VX Hilversum, The Netherlands
| | - Frits M E Franssen
- Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, Horn 6085 NM, The Netherlands
| | - Martijn A Spruit
- Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, Horn 6085 NM, The Netherlands; Faculty of Medicine and Life Sciences, REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Hasselt University, Agoralaan gebouw A, 3590, Diepenbeek, Belgium
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Musculoskeletal disorders in chronic obstructive pulmonary disease. BIOMED RESEARCH INTERNATIONAL 2014; 2014:965764. [PMID: 24783225 PMCID: PMC3982416 DOI: 10.1155/2014/965764] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 02/13/2014] [Indexed: 12/17/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by airway obstruction and inflammation but also accompanied by several extrapulmonary consequences, such as skeletal muscle weakness and osteoporosis. Skeletal muscle weakness is of major concern, since it leads to poor functional capacity, impaired health status, increased healthcare utilization, and even mortality, independently of lung function. Osteoporosis leads to fractures and is associated with increased mortality, functional decline, loss of quality of life, and need for institutionalization. Therefore, the presence of the combination of these comorbidities will have a negative impact on daily life in patients with COPD. In this review, we will focus on these two comorbidities, their prevalence in COPD, combined risk factors, and pathogenesis. We will try to prove the clustering of these comorbidities and discuss possible preventive or therapeutic strategies.
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The effects of elastic tubing-based resistance training compared with conventional resistance training in patients with moderate chronic obstructive pulmonary disease: a randomized clinical trial. Clin Rehabil 2014; 28:1096-106. [DOI: 10.1177/0269215514527842] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity, muscle strength, fat-free mass, and systemic inflammation in patients with chronic obstructive pulmonary disease. Design: A prospective, randomized, eight-week clinical trial. Setting: The study was conducted in a university-based, outpatient, physical therapy clinic. Subjects: A total of 49 patients with moderate chronic obstructive pulmonary disease. Interventions: Participants were randomly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks. Main measures: The primary outcome measure was functional exercise capacity. The secondary outcome measures were peripheral muscle strength, health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire (CRDQ), fat-free mass, and cytokine profile. Results: After eight weeks, the mean distance covered during six minutes increased by 73 meters (±69) in the elastic tubing group and by 42 meters (±59) in the conventional group ( p < 0.05). The muscle strength and quality of life improved in both groups ( P < 0.05), with no significant differences between the groups. There was a trend toward an improved fat-free mass in both groups ( P = 0.05). After the first and last sessions, there was an increase in interleukin 1β (IL-1β) and interleukin 10 (IL-10) in both groups, while tumour necrosis factor alpha (TNF-α) was stimulated only in the conventional training group. Conclusion: Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training. Both interventions were equally effective in improving muscle strength and quality of life.
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Parsons T. Clinician's Commentary on Sawant et al. Physiother Can 2014; 66:54-5. [DOI: 10.3138/ptc.2012-59-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Trisha Parsons
- School of Rehabilitation Therapy, Queen's University, Kingston, Ont
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Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WDC, Pitta F, Sewell L, Raskin J, Bourbeau J, Crouch R, Franssen FME, Casaburi R, Vercoulen JH, Vogiatzis I, Gosselink R, Clini EM, Effing TW, Maltais F, van der Palen J, Troosters T, Janssen DJA, Collins E, Garcia-Aymerich J, Brooks D, Fahy BF, Puhan MA, Hoogendoorn M, Garrod R, Schols AMWJ, Carlin B, Benzo R, Meek P, Morgan M, Rutten-van Mölken MPMH, Ries AL, Make B, Goldstein RS, Dowson CA, Brozek JL, Donner CF, Wouters EFM. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188:e13-64. [PMID: 24127811 DOI: 10.1164/rccm.201309-1634st] [Citation(s) in RCA: 2147] [Impact Index Per Article: 195.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our knowledge of its efficacy and scope. PURPOSE The purpose of this Statement is to update the 2006 document, including a new definition of pulmonary rehabilitation and highlighting key concepts and major advances in the field. METHODS A multidisciplinary committee of experts representing the ATS Pulmonary Rehabilitation Assembly and the ERS Scientific Group 01.02, "Rehabilitation and Chronic Care," determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant clinical and scientific expertise. The final content of this Statement was agreed on by all members. RESULTS An updated definition of pulmonary rehabilitation is proposed. New data are presented on the science and application of pulmonary rehabilitation, including its effectiveness in acutely ill individuals with chronic obstructive pulmonary disease, and in individuals with other chronic respiratory diseases. The important role of pulmonary rehabilitation in chronic disease management is highlighted. In addition, the role of health behavior change in optimizing and maintaining benefits is discussed. CONCLUSIONS The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.
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Ennis S, Alison J, McKeough Z. The effects of arm endurance and strength training on arm exercise capacity in people with chronic obstructive pulmonary disease. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331909x12488667116970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Influence of a moderate physical activity intervention on red cell deformability in patients suffering from chronic obstructive pulmonary disease (COPD). Wien Med Wochenschr 2013; 163:334-9. [PMID: 23423662 DOI: 10.1007/s10354-013-0183-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
Abstract
The present study investigates whether a moderate physical activity intervention may alter red cell deformability (RCD) of patients suffering from chronic obstructive pulmonary disease (COPD). Subjects (n = 10; age: 62 ± 4; body-mass index (BMI): 25.8 ± 7.5) performed a training regimen for 10 weeks. In the beginning of the study and after the training period, COPD patients underwent a WHO cycle ergometry test. Venous blood samples were taken before (T0), immediately after (T1) and 30 min after (T2) the intervention. RCD was measured with the laser-assisted optical rotational cell analyzer (LORCA). Significant improvements of the RCD were detected. The semi-maximal shear stress increased significantly. Acute exhaustion had no effect on RCD. Thus, the training period of 10 weeks influenced RCD.
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Furness T, Bate N, Welsh L, Naughton G, Lorenzen C. Efficacy of a whole-body vibration intervention to effect exercise tolerance and functional performance of the lower limbs of people with chronic obstructive pulmonary disease. BMC Pulm Med 2012; 12:71. [PMID: 23181339 PMCID: PMC3538660 DOI: 10.1186/1471-2466-12-71] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 11/16/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a respiratory condition characterised by dyspnoea, excessive sputum production, chronic cough, bronchitis and emphysema. Functionally, exercise tolerance is poor for people with COPD and is linked to difficulty in performing daily tasks. More specifically, exercise difficulties are due partly to dyspnoea and lower limb skeletal muscle dysfunction. The benefit of exercise that does not exacerbate the disease while improving exercise tolerance is salient. Whole-body vibration (WBV) is a mode of physical activity known to improve muscular function of the lower limbs, yet efficacy has not been investigated for a WBV intervention conducted in a home-based setting for people with COPD. METHODS/DESIGN This clinically registered trial is a non-randomised placebo cross-over intervention based in the home of each participant (ACTRN12612000508875). Participants diagnosed with COPD will complete a six-week WBV intervention and then after a two-week washout period, will complete a six-week placebo training intervention. Participants will complete sessions twice a week. The duration of the trial is 14 weeks. Community-dwelling older adults with COPD will provide informed voluntary consent to participate. Outcome measures will include immediate, acute, and long-term responses to exercise. DISCUSSION Quantifying responses to WBV among people with COPD will allow discussion of efficacy of WBV as a mode of physical activity. The skill required by the participant to perform physical activity with WBV is not demanding and may enhance habitual sustainability. The results of this trial could be used to support further research in both clinical and community settings. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR12612000508875).
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Affiliation(s)
- Trentham Furness
- Department of Medicine, Monash University, Monash Medical Centre, Clayton, Australia
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
- Monash Medical Centre, Southern Health, Clayton, Australia
| | - Nicole Bate
- Monash Medical Centre, Southern Health, Clayton, Australia
| | - Liam Welsh
- The Royal Children’s Hospital, Melbourne, Australia
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Christian Lorenzen
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
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Kathiresan G, Jeyaraman SK, Jaganathan J. Effect of upper extremity exercise in people with COPD. J Thorac Dis 2012; 2:223-36. [PMID: 22263051 DOI: 10.3978/j.issn.2072-1439.2010.11.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Accepted: 11/11/2010] [Indexed: 11/14/2022]
Abstract
BACKGROUND Exercise for people with COPD has focused on leg training, such as walking and cycling. The role and effectiveness of arm training has not been investigated in detail. This review was undertaken to examine the literature for the effectiveness of upper extremity exercise on arm exercise capacity and arm strength in people with COPD. METHODS Trials relating to arm endurance and strength training in COPD were located by searching electronic databases and screening the reference lists of pertinent articles. Where possible, effect sizes and 95% CI were determined and meta-analysis used. RESULTS The search strategy yielded 24 articles. Unsupported arm training improved arm endurance capacity (standard mean difference [SMD] =1.25; 95% CI=0.16 to 2.66) and was the optimal mode of arm endurance training. Combined unsupported and supported arm training was also found to have a large positive effect on peak arm exercise capacity (SMD=1.27; 95% CI=0.59 to 1.94). In addition arm strength training produced moderate improvements in arm strength (SMD=0.46; 95% CI=0.10 to 0.81). CONCLUSION This review suggests that in the short term, arm endurance training improves arm exercise capacity and arm strength training improves arm strength. Further research is required, in people with COPD, to investigate the long-term effects of arm training.
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Affiliation(s)
- Ganesan Kathiresan
- School of Therapeutic sciences, Masterskill University College, Malaysia
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McKeough ZJ, Bye PTP, Alison JA. Arm exercise training in chronic obstructive pulmonary disease. Chron Respir Dis 2012; 9:153-162. [DOI: 10.1177/1479972312440814] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
The aim of this study was to compare the effects of arm endurance training, arm strength training, a combination of arm endurance and strength training, and no arm training on endurance arm exercise capacity. A randomised controlled trial was undertaken with chronic obstructive pulmonary disease subjects randomised into one of four groups to complete 8 weeks of training: (a) arm endurance training (endurance group) consisting of supported and unsupported arm exercises, (b) arm strength training (strength group) using weight machines, (c) a combination of arm endurance and arm strength training (combined group), or (d) no arm training (control group). The primary outcome measurement was endurance arm exercise capacity measured by an endurance arm crank test. Secondary outcomes included functional arm exercise capacity measured by the incremental unsupported arm exercise test and health-related quality of life. A total of 52 subjects were recruited and 38 (73%) completed the study. When comparing the arm endurance group to the control group, there was a significant increase in endurance time of 6 min (95% CI 2–10, p < 0.01) following the interventions. When comparing the combined group to each of the control, endurance and strength groups, there was a significantly greater reduction in dyspnoea and rate of perceived exertion at the end of the functional arm exercise test for the combined group following the interventions. The mode of training to be favoured to increase endurance arm exercise capacity is arm endurance training. However, combined arm endurance and strength training may also be very useful to reduce the symptoms during everyday arm tasks.
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Affiliation(s)
- Zoe J McKeough
- Discipline of Physiotherapy, Clinical and Rehabilitation Sciences, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - Peter TP Bye
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia
- Woolcock Institute of Medical Research, Sydney, Australia
- Faculty of Medicine, The University of Sydney, Australia
| | - Jennifer A Alison
- Discipline of Physiotherapy, Clinical and Rehabilitation Sciences, Faculty of Health Sciences, The University of Sydney, NSW, Australia
- Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia
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Nyberg A, Lindström B, Wadell K. Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial. Trials 2012; 13:114. [PMID: 22823966 PMCID: PMC3443039 DOI: 10.1186/1745-6215-13-114] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 07/23/2012] [Indexed: 11/28/2022] Open
Abstract
Background Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Since the positive local physiological effects of exercise training only occur in the engaged muscle(s), should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients. Methods/design Trial design: a prospective, assessor-blind, block randomized controlled, parallel-group multicenter trial. Participants: stage II-IV COPD patients, > 40 years of age, ex-smokers, with stable medical treatment will be included starting May 2011. Recruitment at three locations in Sweden. Interventions: 1) high-repetitive single limb exercise (HRSLE) training with elastic bands, 60 minutes, three times/week for 8 weeks combined with four sessions of 60 minutes patient education, or 2) the same patient education alone. Outcomes: Primary: determine the effects of HRSLE on local muscle endurance capacity (measured as meters walked during 6-minute walk test and rings moved on 6-minute ring and pegboard test) and quality of life (measured as change on the Swedish version of the Chronic Respiratory Disease Questionnaire). Secondary: effects on maximal strength, muscular endurance, dyspnea, self-efficacy, anxiety and depression. The relationship between changes in health-related variables and changes in exercise capacity, sex-related differences in training effects, feasibility of the program, strategies to determine adequate starting resistance and provide accurate resistance for each involved movement and the relationship between muscle fatigue and dyspnea in the different exercise tests will also be analyzed. Randomization: performed by a person independent of the recruitment process and using a computer random number generator. Stratification by center and gender with a 1:1 allocation to the intervention or control using random block sizes. Blinding: all outcome assessors will be blinded to group assignment. Discussion The results of this project will contribute to increase the body of knowledge regarding COPD and HRSLE. Trial registration ClinicalTrials.gov Identifier: NCT01354067. Registration date: 2011-05-11. First participant randomized: 2011-09-02
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Affiliation(s)
- Andre Nyberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå 90187, Sweden.
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Vonbank K, Strasser B, Mondrzyk J, Marzluf BA, Richter B, Losch S, Nell H, Petkov V, Haber P. Strength training increases maximum working capacity in patients with COPD--randomized clinical trial comparing three training modalities. Respir Med 2011; 106:557-63. [PMID: 22119456 DOI: 10.1016/j.rmed.2011.11.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 11/07/2011] [Accepted: 11/09/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Skeletal muscle dysfunction contributes to exercise limitation in patients with chronic obstructive pulmonary disease (COPD). Strength training increases muscle strength and muscle mass, but there is an ongoing debate on the additional effect concerning the exercise capacity. The purpose of this study was to compare the effects of three different exercise modalities in patients with COPD including endurance training (ET), progressive strength training (ST) and the combination of strength training and endurance training (CT). DESIGN A prospective randomized trial. METHODS Thirty-six patients with COPD were randomly allocated either to ET, ST, or CT. Muscle strength, cardiopulmonary exercise testing, lung function testing and quality of life were assessed before and after a 12-week training period. RESULTS Exercise capacity (Wmax) increased significantly in all three training groups with increase of peak oxygen uptake (VO2peak) in all three groups, reaching statistical significance in the ET group and the CT group. Muscle strength (leg press, bench press, bench pull) improved in all three training groups, with a higher improvement in the ST (+39.3%, +20.9%, +20.3%) and the CT group (+43.3%, +18.1%, +21.6%) compared to the ET group (+20.4%, +6.4%, +12.1%). CONCLUSIONS Progressive strength training alone increases not only muscle strength and quality of life, but also exercise capacity in patients with COPD, which may have implications in prescription of training modality. CLINICALTRIALS.GOV IDENTIFIER: NCT01091623.
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Affiliation(s)
- Karin Vonbank
- Department of Internal Medicine II, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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