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Nangliya R, Yadav V, Nandanwar SP. Novelty of Physiotherapy Management in a Classic Case of Chronic Obstructive Pulmonary Disease in an 84-Year-Old Male Patient with Hypertension and Well-Controlled Hypothyroidism: A Case Report. Cureus 2024; 16:e57318. [PMID: 38690482 PMCID: PMC11060019 DOI: 10.7759/cureus.57318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) often coexists with hypertension and hypothyroidism, posing challenges in management. Physiotherapy is crucial for improving respiratory function and quality of life in COPD patients. This case report details the physiotherapy management of an 84-year-old male with COPD, hypertension, and well-controlled hypothyroidism. The patient presented with worsening cough, breathlessness, and barrel chest. Diagnostic investigations confirmed COPD with respiratory alkalosis, hypoxemia, and well-controlled hypothyroidism. Pharmaceutical management was initiated alongside intensive physiotherapy interventions. A two-week rehabilitation program was tailored to the patient's COPD condition. It included deep breathing exercises, relaxation techniques, and aerobic activities to improve respiratory function and exercise tolerance. Physiotherapy sessions focused on patient education with medical treatment. Significant improvements were noted in dyspnea grading, perceived exertion rate, and thoracic excursion post-rehabilitation. Follow-up assessments showed sustained benefits with improved daily activities and reduced dyspnea. This case underscores the efficacy of multidisciplinary management, highlighting the essential role of physiotherapy in optimizing outcomes for COPD patients with comorbidities.
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Affiliation(s)
- Radha Nangliya
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vaishnavi Yadav
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sojwal P Nandanwar
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Shah BK, Singh B, Wang Y, Xie S, Wang C. Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease and Its Treatment. Mediators Inflamm 2023; 2023:8840594. [PMID: 37457746 PMCID: PMC10344637 DOI: 10.1155/2023/8840594] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/29/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Most patients diagnosed with chronic obstructive pulmonary disease (COPD) present with hallmark features of airway mucus hypersecretion, including cough and expectoration. Airway mucus function as a native immune system of the lung that severs to trap particulate matter and pathogens and allows them to clear from the lung via cough and ciliary transport. Chronic mucus hypersecretion (CMH) is the main factor contributing to the increased risk of morbidity and mortality in specific subsets of COPD patients. It is, therefore, primarily important to develop medications that suppress mucus hypersecretions in these patients. Although there have been some advances in COPD treatment, more work remains to be done to better understand the mechanism underlying airway mucus hypersecretion and seek more effective treatments. This review article discusses the structure and significance of mucus in the lungs focusing on gel-forming mucins and the impacts of CMH in the lungs. Furthermore, we summarize the article with pharmacological and nonpharmacological treatments as well as novel and interventional procedures to control CMH in COPD patients.
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Affiliation(s)
- Binay Kumar Shah
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
- Tongji University School of Medicine, Shanghai 200092, China
| | - Bivek Singh
- Tongji University School of Medicine, Shanghai 200092, China
| | - Yukun Wang
- Tongji University School of Medicine, Shanghai 200092, China
| | - Shuanshuan Xie
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Changhui Wang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
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Marques GÁ, de Oliveira PD, Montzel M, Menezes AMB, Malta DC, Sardinha LMV, Wehrmeister FC. Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013. Rev Saude Publica 2023; 56:119. [PMID: 36629710 PMCID: PMC9749731 DOI: 10.11606/s1518-8787.2022056004090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/18/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of treatments used for the management of chronic obstructive pulmonary disease (COPD) in the Brazilian adult population. METHODS A population-based cross-sectional study with data from the 2013 Brazilian National Survey of Health, including individuals aged 40 years or older, with a self-reported medical diagnosis of COPD, chronic bronchitis and/or emphysema, who were asked about treatments used for disease management. RESULTS A total of 60,202 adults were interviewed, of which 636 were 40 years of age or older and had reported a medical diagnosis of COPD, emphysema, or chronic bronchitis. Less than half (49.4%) of the diagnosed population reported using some type of treatment, with differences regarding the macro-region of the country (South 53.8% - Northeast 41.2%, p = 0.007). Pharmacological treatment was the most reported, and emphysema patients had the highest proportion of those undergoing more than one type of treatment. Among the individuals who reported having only chronic bronchitis, 55.1% (95%CI: 48.7-61.4) used medication, 4.7% (95%CI: 2.6-8.3) underwent physical therapy, and 6.0% (95%CI: 3.6-9.9) oxygen therapy. On the other hand, among the emphysema patients, 44.1% (95%CI: 36.8-51.7) underwent drug treatment, 8.8% (95%CI: 5.4-14.2) physical therapy, and 10.0% (95%CI: 6.3-15.6) oxygen therapy. CONCLUSION The prevalence of treatments for COPD management was below ideal in 2013. The pharmacological treatment was the main type of treatment, followed by oxygen therapy and physical therapy.
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Affiliation(s)
- Gabriela Ávila Marques
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Paula Duarte de Oliveira
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Marina Montzel
- Universidade Federal de PelotasFaculdade de MedicinaDepartamento de Medicina SocialPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Ana Maria Baptista Menezes
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | | | - Fernando César Wehrmeister
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
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Verburg AC, Zincken J, Kiers H, van Dulmen SA, van der Wees PJ. Experiences of physiotherapists regarding a standard set of measurement instruments to improve quality of care for patients with chronic obstructive pulmonary disease: a mixed methods study. J Patient Rep Outcomes 2022; 6:79. [PMID: 35852671 PMCID: PMC9296726 DOI: 10.1186/s41687-022-00487-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Rationale
The quality of physiotherapy care for patients with chronic obstructive pulmonary disease (COPD) can be improved by comparing outcomes of care in practice.
Aim
To evaluate the experiences of physiotherapists implementing a standard set of measurement instruments to measure outcomes and improve the quality of care for patients with COPD.
Methods
This sequential explanatory mixed methods study was performed in two parts. In the quantitative part, a survey of 199 physiotherapists was conducted to evaluate their attitudes and knowledge, as well as the influence of contextual factors (i.e., practice policy and support from colleagues), in the implementation of the standard measurement set. In the qualitative part, 11 physiotherapists participated in individual interviews to elucidate their experiences using a thematical framework.
Results
The survey showed that, on average, 68.4% of the physiotherapists reported having a positive attitude about using the standard set, 85.0% felt they had sufficient knowledge of the measurement instruments, and 84.7% felt supported by practice policy and colleagues. In total, 80.3% of physiotherapists thought the standard set had added value in clinical practice, and 90.3% indicated that the measurement instruments can be valuable for evaluating treatment outcomes. The physiotherapists mentioned several barriers, such as lack of time and the unavailability of the entire standard set of measurement instruments in their practice. Moreover, the physiotherapists indicated that the measurement instruments have added value in providing transparency to policymakers through the anonymized publication of outcomes.
Conclusion
Physiotherapists support the use of the standard set of measurement instruments to improve the quality of physiotherapy treatment for patients with COPD.
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Bhagwani RS, Yadav V, Dhait SR, Karanjkar SM, Nandanwar RR. Elementary Pulmonary Rehabilitation Protocol to Ameliorate Functionality Level in Case of Pneumothorax Following Emphysema: A Case Report. Cureus 2022; 14:e31421. [DOI: 10.7759/cureus.31421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/12/2022] [Indexed: 11/15/2022] Open
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Yakutcan U, Hurst JR, Lebcir R, Demir E. Assessing the impact of COVID-19 measures on COPD management and patients: a simulation-based decision support tool for COPD services in the UK. BMJ Open 2022; 12:e062305. [PMID: 36207043 PMCID: PMC9556746 DOI: 10.1136/bmjopen-2022-062305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To develop a computer-based decision support tool (DST) for key decision makers to safely explore the impact on chronic obstructive pulmonary disease (COPD) care of service changes driven by restrictions to prevent the spread of COVID-19. DESIGN The DST is powered by discrete event simulation which captures the entire patient pathway. To estimate the number of COPD admissions under different scenario settings, a regression model was developed and embedded into the tool. The tool can generate a wide range of patient-related and service-related outputs. Thus, the likely impact of possible changes (eg, COVID-19 restrictions and pandemic scenarios) on patients with COPD and care can be estimated. SETTING COPD services (including outpatient and inpatient departments) at a major provider in central London. RESULTS Four different scenarios (reflecting the UK government's Plan A, Plan B and Plan C in addition to a benchmark scenario) were run for 1 year. 856, 616 and 484 face-to-face appointments (among 1226 clinic visits) are expected in Plans A, B and C, respectively. Clinic visit quality in Plan A is found to be marginally better than in Plans B and C. Under coronavirus restrictions, lung function tests decreased more than 80% in Plan C as compared with Plan A. Fewer COPD exacerbation-related admissions were seen (284.1 Plan C vs 395.1 in the benchmark) associated with stricter restrictions. Although the results indicate that fewer quality-adjusted life years (in terms of COPD management) would be lost during more severe restrictions, the wider impact on physical and mental health must also be established. CONCLUSIONS This DST will enable COPD services to examine how the latest developments in care delivery and management might impact their service during and beyond the COVID-19 pandemic, and in the event of future pandemics.
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Affiliation(s)
- Usame Yakutcan
- Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Reda Lebcir
- Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
| | - Eren Demir
- Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
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The Possible Impact of COVID-19 on Respiratory Muscles Structure and Functions: A Literature Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14127446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The impact of SARS-CoV-2 infection on respiratory muscle functions is an important area of recent enquiry. COVID-19 has effects on the respiratory muscles. The diaphragm muscle is perturbed indirectly due to the mechanical-ventilation-induced-disuse, but also by direct mechanisms linked with SARS-CoV-2 viral infection. In this sense, a deeper understanding of the possible links between COVID-19 and alterations in structure and functions of the respiratory muscles may increase the success rate of preventive and supportive strategies. Ultrasound imaging alongside respiratory muscle strength tests and pulmonary function assessment are valid approaches to the screening and monitoring of disease, for mild to severe patients. The aim of the present review is to highlight the current literature regarding the links between COVID-19 and respiratory muscle functions. We examine from the pathophysiological aspects of disease, up to approaches taken to monitor and rehabilitate diseased muscle. We hope this work will add to a greater understanding of the pathophysiology and disease management of respiratory muscle pathology subsequent to SARS-CoV-2 infection.
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Román-Rodríguez M, Kocks JWH. Targeting exertional breathlessness to improve physical activity: the role of primary care. NPJ Prim Care Respir Med 2021; 31:41. [PMID: 34504091 PMCID: PMC8429707 DOI: 10.1038/s41533-021-00254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/19/2021] [Indexed: 02/08/2023] Open
Abstract
Primary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients' avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.
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Affiliation(s)
- Miguel Román-Rodríguez
- Son Pisà Primary Health Care Centre, Balearic Health System, Mallorca, Spain.
- Primary Care Chronic Respiratory Research Unit, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Mallorca, Spain.
| | - Janwillem W H Kocks
- General Practitioners Research Institute, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Observational and Pragmatic Research Institute, Singapore, Singapore
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