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Boeselt T, Terhorst P, Kroenig J, Nell C, Spielmanns M, Boas U, Veith M, Vogelmeier C, Greulich T, Koczulla AR, Beutel B, Huber J, Heers H. Specific molecular peak analysis by ion mobility spectrometry of volatile organic compounds in urine of COVID-19 patients: A novel diagnostic approach. J Virol Methods 2024; 326:114910. [PMID: 38452823 DOI: 10.1016/j.jviromet.2024.114910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/08/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION SARS-CoV-2 is usually diagnosed from naso-/oropharyngeal swabs which are uncomfortable and prone to false results. This study investigated a novel diagnostic approach to Covid-19 measuring volatile organic compounds (VOC) from patients' urine. METHODS Between June 2020 and February 2021, 84 patients with positive RT-PCR for SARS-CoV-2 were recruited as well as 54 symptomatic individuals with negative RT-PCR. Midstream urine samples were obtained for VOC analysis using ion mobility spectrometry (IMS) which detects individual molecular components of a gas sample based on their size, configuration, and charge after ionization. RESULTS Peak analysis of the 84 Covid and 54 control samples showed good group separation. In total, 37 individual specific peaks were identified, 5 of which (P134, 198, 135, 75, 136) accounted for significant differences between groups, resulting in sensitivities of 89-94% and specificities of 82-94%. A decision tree was generated from the relevant peaks, leading to a combined sensitivity and specificity of 98% each. DISCUSSION VOC-based diagnosis can establish a reliable separation between urine samples of Covid-19 patients and negative controls. Molecular peaks which apparently are disease-specific were identified. IMS is an additional non-invasive and cheap device for the diagnosis of this ongoing endemic infection. Further studies are needed to validate sensitivity and specificity.
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Affiliation(s)
- T Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - P Terhorst
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Kroenig
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Nell
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Spielmanns
- Pulmonary Rehabilitation, Zuercher Reha Zentren Klinik Wald, Switzerland; Faculty of Health, Department of Pneumology, University of Witten, Herdecke, Germany
| | - U Boas
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - A R Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany; Department of Pulmonology, Schoen-Kliniken Berchtesgaden, Philipps-University Marburg, Germany
| | - B Beutel
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Huber
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany
| | - H Heers
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany.
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2
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Luu P, Tulka S, Knippschild S, Windisch W, Spielmanns M. [Risk Assessment of Acute Exacerbation in COPD Patients in the Context of Pulmonary Follow-Up Rehabilitation Based on the Prevalence and Severity of Comorbidities]. Pneumologie 2021; 75:516-525. [PMID: 33540464 DOI: 10.1055/a-1346-5504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Acute COPD exacerbations (AECOPD) in the context of pulmonary rehabilitation (PR) are frequent and dangerous complications and, in addition to impairing quality of life, lead to an interruption of PR and jeopardize PR success. In this study, a correlation between the health status and an increased risk of AECOPD is described. The question arises whether the Charlson Comorbidity Index (CCI) or the Cumulative Illness Rating Scale (CIRS) are suitable for the preventive detection of COPD patients at risk for exacerbation in PR. PATIENTS AND METHODS In a retrospective study, data of COPD patients who underwent PR in 2018 were analyzed with the CCI as the primary endpoint. All data were taken from the Phoenix Clinical Information System, and COPD exacerbations were recorded. The 44 patients (22 with and 22 without exacerbation during PR) required according to the sample size planning were randomly recruited from this pool of patients (using a random list for each group). CCI and CIRS were determined for all the cases included in the two groups. The primary endpoint (CCI) was evaluated by group comparison of the arithmetic means and Welch test. This was supported by further statistical measures of position and dispersion (median, quartile, standard deviation).In addition, the optimal cut-off point for discrimination in AECOPD and non-AECOPD patients was obtained via Receiver Operating Characteristic (ROC) analysis for both the CCI and the CIRS. RESULTS Out of 244 COPD patients who underwent PR for an average of 21 days, 59 (24 %) suffered AECOPD that required treatment during PR. The 22 patients with AECOPD had a mean CCI of 6.77 (SD: 1.97) and the 22 patients without AECOPD had a mean CCI of 4.32 (SD: 1.17). This difference of -2.45 was statistically significant at a level of significance of 5 % (p < 0.001; 95 % CI: [-3.45; -1.46]). The ROC analysis led to 6 as the optimal cut-off point for the CCI, with 81.8 % sensitivity for determining an AECOPD and 86.4 % specificity with an area under the curve (AUC) value of 0.87. The optimal cut-off point for CIRS was 19 with a sensitivity of 50 %, a specificity of 77.2 % and an AUC of 0.65. CONCLUSION COPD patients with acute exacerbation during PR have a higher CCI. The CCI allows the risk of AECOPD to be assessed with high sensitivity and specificity in participants with COPD in an inpatient PR program.
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Affiliation(s)
- P Luu
- Pneumologie, Zürcher RehaZentren Klinik Wald, Wald-ZH (Schweiz)
| | - S Tulka
- Pneumologie, Zürcher RehaZentren Klinik Wald, Wald-ZH (Schweiz).,Institut für medizinische Biometrie und Epidemiologie, Universität Witten/Herdecke, Witten
| | - S Knippschild
- Institut für medizinische Biometrie und Epidemiologie, Universität Witten/Herdecke, Witten
| | - W Windisch
- Fakultät für Gesundheit, Lehrstuhl für Pneumologie, Universität Witten/Herdecke, Witten.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln
| | - M Spielmanns
- Pneumologie, Zürcher RehaZentren Klinik Wald, Wald-ZH (Schweiz).,Fakultät für Gesundheit, Lehrstuhl für Pneumologie, Universität Witten/Herdecke, Witten
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3
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Worth H, Bock R, Frisch M, Göhl O, Grünig E, Glöckl R, Limbach M, Schultz K, Spielmanns M, Taube K, Teschler S, Watz H. [Group Training of Patients with Chronic Lung Diseases under Outpatient Conditions - Recommendations of the Working Group Lung Sports in Germany and the German Airways League]. Pneumologie 2021. [PMID: 33212518 DOI: 10.1055/a-1310-2400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - R Bock
- Gemeinschaftspraxis Dres. Rüdiger Bock, Maria Develaska und Christiane Rozeh, Hamburg
| | | | | | - E Grünig
- Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Zentrum für pulmonale Hypertonie, Heidelberg
| | - R Glöckl
- Schön Klinik Berchtesgadener Land, Schönau am Königssee
| | - M Limbach
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - K Schultz
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - M Spielmanns
- Zürcher RehaZentren Klinik Wald, Wald, Schweiz.,Department für Gesundheit, Lehrstuhl für Pneumologie, Universität Witten-Herdecke, Witten
| | | | | | - H Watz
- Pneumologisches Forschungsinstitut an der LungenClinic Großhansdorf, Airway Research Center North (ARCN), Deutsches Zentrum für Lungenforschung (DZL), Großhansdorf
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4
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Worth H, Bock R, Frisch M, Göhl O, Grünig E, Glöckl R, Limbach M, Schultz K, Spielmanns M, Taube K, Teschler S, Watz H. [Group Training of Patients with Chronic Lung Diseases under Outpatient Conditions - Recommendations of the Working Group Lung Sports in Germany and the German Airways League]. Pneumologie 2021; 75:44-56. [PMID: 33167049 DOI: 10.1055/a-1224-6024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
To improve acceptance and use of physical training by patients with chronic lung diseases, recommendations for performing lung exercises on an outpatient basis in a group setting are given by experts in physical training, sports therapists and pulmonologists. The evidence-based positive effects of physical training were analyzed for asthma , COPD, interstitial lung diseases, cystic fibrosis, lung carcinoma, and pulmonary hypertension. The requirements for lung exercises in outpatient groups as well as compensation by care providers were given on the basis of legal regulations. Furthermore, the main items of the training units as well as supervision by specially trained group leaders in relation to the severity of the underlying lung disease are described. Finally, aspects of safety of the participating patients are discussed, including the prevention of infection with corona-2-virus.
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Affiliation(s)
| | - R Bock
- Gemeinschaftspraxis Dres. Rüdiger Bock, Maria Develaska und Christiane Rozeh, Hamburg
| | | | | | - E Grünig
- Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Zentrum für pulmonale Hypertonie, Heidelberg
| | - R Glöckl
- Schön Klinik Berchtesgadener Land, Schönau am Königssee
| | - M Limbach
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - K Schultz
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - M Spielmanns
- Zürcher RehaZentren Klinik Wald, Wald, Schweiz.,Department für Gesundheit, Lehrstuhl für Pneumologie, Universität Witten-Herdecke, Witten
| | | | | | - H Watz
- Pneumologisches Forschungsinstitut an der LungenClinic Großhansdorf, Airway Research Center North (ARCN), Deutsches Zentrum für Lungenforschung (DZL), Großhansdorf
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5
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Glöckl R, Buhr-Schinner H, Koczulla AR, Schipmann R, Schultz K, Spielmanns M, Stenzel N, Dewey S. [Recommendations from the German Respiratory Society for Pulmonary Rehabilitation in Patients with COVID-19]. Pneumologie 2020; 74:496-504. [PMID: 32583378 PMCID: PMC7516360 DOI: 10.1055/a-1193-9315] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vor dem Hintergrund der Pandemie durch Infektionen mit dem SARS-CoV-2 hat die Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP e. V.) die Sektion 12 „Rehabilitation, Prävention und Tabakkontrolle“ beauftragt, Empfehlungen zur Umsetzung pneumologischer Rehabilitation bei Patienten nach COVID-19 zu erstellen. Dieses Positionspapier basiert auf dem momentanen aktuellen Wissen, das sich täglich weiterentwickelt. Neben einer Beschreibung der gesundheitlichen Folgen von COVID-19 wird die Indikationsstellung aufgezeigt. Rehabilitative Therapien bei COVID-19 sind bereits auf der Normalstation bzw. Intensivstation indiziert, setzen sich fort als pneumologische Frührehabilitation im Akutkrankenhaus und als Anschlussheilbehandlung oder Reha-Heilverfahren in pneumologischen Rehabilitationskliniken. Im Fokus dieses Positionspapiers stehen Empfehlungen zur inhaltlichen Durchführung einer multimodalen, interdisziplinären pneumologischen Rehabilitation bei COVID-19.
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Affiliation(s)
- R Glöckl
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Schönau am Königssee.,Philipps-Universität Marburg, Abteilung für Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) Marburg
| | - H Buhr-Schinner
- Ostseeklinik Schönberg-Holm, Abteilung Pneumologie, Schönberg
| | - A R Koczulla
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Schönau am Königssee.,Philipps-Universität Marburg, Abteilung für Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) Marburg.,Lehrkrankenhaus Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
| | - R Schipmann
- Klinik Martinusquelle, Abteilung Pneumologie und Kardiologie, MZG Bad Lippspringe, Bad Lippspringe
| | - K Schultz
- Klinik Bad Reichenhall der Deutschen Rentenversicherung Bayern Süd, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - M Spielmanns
- Pneumologie Zürcher RehaZentren Klinik Wald, Schweiz und Medizinische Fakultät, Lehrstuhl für Pneumologie Universität Witten-Herdecke, Witten
| | - N Stenzel
- Psychologische Hochschule Berlin (PHB), Berlin
| | - S Dewey
- Strandklinik St. Peter-Ording, Abteilung für Pneumologie, St. Peter-Ording
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6
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Spielmanns M, Müller K, Schott N, Winkler A, Polanski H, Nell C, Boeselt T, Koczulla AR, Storre JH, Windisch W, Magnet FS, Baum K. [Impact of a Senso-Motoric Intervention in COPD-Patients Participating in an Outpatient Pulmonary Rehabilitation Program: A Randomized Controlled Trial]. REHABILITATION 2017; 56:159-166. [PMID: 28231596 DOI: 10.1055/s-0042-119248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective Exercise training provides a cornerstone of pulmonary rehabilitation (PR) in COPD-patients. However, the components of the training are not yet fully investigated. We conducted a randomized controlled trial to investigate the effectiveness of a sensory-motoric training (SMT) in comparison to a conventional strength training (KT) according to the physical performance. Patients and Methods: 43 COPD patients were randomized and participated either in the intervention group (SMT = 30 minutes SMT per day) or in the control group (KT = 30 minutes KT per day). The SMT was performed as circuit training with five stations. The primary endpoint was the difference between T1 (start of the PR) and T2 (end of the PR) in 5-Times Sit-to-stand test (5-STST) in the intergroup comparison. Secondary endpoints were the intra- and intergroup comparisons of T1 and T2 in the 6-Minute Walk Test (6-MWT), COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), Hospital Anxiety- and Depression Scale (HADS) and in lung function. Results No significant differences were seen in the results of the 5-STST between the groups. Likewise, in the 6-MWT, SGRQ, CAT, HADS and lung function. The intragroup comparison between T1 and T2 showed significant differences in 5-STST, 6-MWT, SGRQ, CAT and HADS in both groups. The differences in lung function were not significantly, neither in the inter- nor in the intragroup comparison. Conclusion Similarly to a conventional strength training improvements in exercise capacity could be achieved with a SMT during PR in COPD patients. Further studies are necessary to define the role of the SMT in regards to postural control.
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Affiliation(s)
- M Spielmanns
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen.,Lehrstuhl Pneumologie, Universität Witten/Herdecke
| | - K Müller
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen
| | - N Schott
- Lehrstuhl Sport- und Gesundheitswissenschaften II, Universität Stuttgart
| | - A Winkler
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen
| | - H Polanski
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin, Philipps-Universität Marburg
| | - T Boeselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin, Philipps-Universität Marburg
| | - A R Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin, Philipps-Universität Marburg
| | - J H Storre
- Universitätsklinikum Freiburg.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
| | - W Windisch
- Lehrstuhl Pneumologie, Universität Witten/Herdecke.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
| | - F S Magnet
- Lehrstuhl Pneumologie, Universität Witten/Herdecke.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
| | - K Baum
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
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7
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Spielmanns M, Müller K, Schott N, Winkler A, Polanski H, Nell C, Böselt T, Koczulla AR, Storre JH, Windisch W, Magnet F, Baum K. Effektivität eines senso-motorischen Krafttrainings im Rahmen einer ambulanten pneumologischen Rehabilitation bei COPD-Patienten: eine randomisierte, kontrollierte Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Spielmanns
- Medizinische Klinik, St. Remigius Krankenhaus, Lehrstuhl Pneumologie, Universität Witten/Herdecke
| | | | | | | | | | | | | | | | | | | | | | - K Baum
- Trainingsinstitut Prof. Baum, Köln
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8
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Magnet F, Callegari J, Dieninghoff D, Spielmanns M, Storre JH, Schmoor C, Windisch W. Der Einfluss der Pseudomonas-aeruginosa-Infektion auf die atemmuskuläre Funktion bei erwachsenen Patienten mit Mukoviszidose. Pneumologie 2017. [DOI: 10.1055/s-0037-1598482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F Magnet
- Lungenklinik – Abt. Pneumologie, Klinken der Stadt Köln gGmbH, Merheim Hospital, University of Witten/Herdecke
| | - J Callegari
- Lungenklinik – Abt. Pneumologie, Klinken der Stadt Köln gGmbH, Merheim Hospital, University of Witten/Herdecke
| | - D Dieninghoff
- Lungenklinik – Abt. Pneumologie, Klinken der Stadt Köln gGmbH, Merheim Hospital, University of Witten/Herdecke
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - JH Storre
- Lungenklinik – Abt. Pneumologie, Klinken der Stadt Köln gGmbH, Merheim Hospital, University of Witten/Herdecke
| | - C Schmoor
- Clinical Trials Center, Universitätsklinik Freiburg
| | - W Windisch
- Lungenklinik – Abt. Pneumologie, Klinken der Stadt Köln gGmbH, Merheim Hospital, University of Witten/Herdecke
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9
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Böselt T, Spielmanns M, Glöckl R, Klutsch A, Fischer H, Polanski H, Nell C, Storre JH, Windisch W, Koczulla AR. Low volume whole body vibration training improves exercise capacity in subjects with mild to severe COPD. Pneumologie 2017. [DOI: 10.1055/s-0037-1598476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Böselt
- Schwerpunkt Pneumologie, Klinik für Innere Medizin, Philipps Universität Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - R Glöckl
- Schön Klinik Berchtesgadener Land, Klinikum Rechts der Isar, Technische Universität München
| | - A Klutsch
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - H Fischer
- Institut für Medizin, Training und Gesundheit, Philipps Universität Marburg
| | - H Polanski
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - C Nell
- Schwerpunkt Pneumologie, Klinik für Innere Medizin, Philipps Universität Marburg
| | - JH Storre
- Abt. Pneumologie, Lungenklinik, Klinken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - W Windisch
- Abt. Pneumologie, Lungenklinik, Klinken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Philipps-Universität Marburg
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Kölpin J, Kaufhold F, Böselt T, Nell C, Herth FJF, Vogelmeier C, Alter P, Kähler CM, Veith M, Greulich T, Spielmanns M, Kenn K, Kreuter M, Koczulla AR. Drei-Center Studie (DZL) zur Untersuchung von Trainingstherapieauswirkungen eines dreimonatigen Ganzkörpervibrationstrainings bei Patienten mit Lungenfibrose auf Muskelkraft, Lungenfunktion, gesundheitsbezogene Lebensqualität und Inflammationsmarker. Pneumologie 2017. [DOI: 10.1055/s-0037-1598477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J Kölpin
- Pneumologie, Philipps Universität Marburg
| | - F Kaufhold
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C Nell
- Pneumologie, Philipps Universität Marburg
| | - FJF Herth
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - P Alter
- Pneumologie, Philipps Universität Marburg
| | | | - M Veith
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
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11
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Spielmanns M, Böselt T, Nell C, Koczulla AR, Magnet F, Storre JH, Windisch W, Baum K. Die Teilnahme von Patienten mit einer COPD an einer ambulanten pneumologischen Rehabilitation führt zu einer Steigerung der Inspirationskapazität im 6-Minutengehtest: eine kontrollierte Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Spielmanns
- St. Remigius Krankenhaus; Medizinische Klinik; Lehrstuhl Pneumologie, Universität Witten/Herdecke
| | | | | | | | | | | | | | - K Baum
- Trainingsistitut Prof. Baum, Köln
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Böselt T, Spielmanns M, Nell C, Storre JH, Windisch W, Magerhans L, Beutel B, Kenn K, Greulich T, Alter P, Vogelmeier C, Koczulla AR. Validity and usability of physical activity monitoring in patients with chronic obstructive pulmonary disease (COPD). Pneumologie 2017. [DOI: 10.1055/s-0037-1598310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - JH Storre
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - W Windisch
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - L Magerhans
- Klinik für Innere Medizin, Schwerpunkt Nephrologie, Philipps Universität Marburg
| | - B Beutel
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - P Alter
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
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Spielmanns M, Axer F, Nell C, Koczulla AR, Boeselt T, Magnet F, Storre JH, Windisch W. [Outcome predictors for COPD patients hospitalized for acute exacerbation]. Med Klin Intensivmed Notfmed 2017; 112:708-716. [PMID: 28044184 DOI: 10.1007/s00063-016-0245-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/11/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prognostic factors for clinical failure of acute exacerbation in patients with COPD (AECOPD) are of special importance in order to choose an adequate therapy and resources during inpatient treatment. Our database was analyzed to identify predictors for a negative outcome. MATERIALS AND METHODS In a retrospective analysis medical records of 616 patients (299 women; 317 men) hospitalized for AECOPD between January 2011 and January 2016 were analyzed in order to evaluate demographic and clinical parameters leading to adverse events. Only the first admission was considered. Logistic regression analysis was performed to determine the relative risk (odds ratio (OR) leading to severe adverse events such as intensive care unit (ICU) admission, mechanical ventilation (invasive or noninvasive), early readmission to ICU and hospital and death). RESULTS An increased risk of an ICU admission was found for patients with a coronary heart disease (OR = 5.734; p = 0.009) and for patients requiring an antibiotic therapy (OR = 11.721; p = 0.003). An increased risk for rehospitalisation and mortality was found for age (OR = 1.034; p = 0.028) and a longer duration of the hospital stay (OR = 1.063; p = 0.042). A lower C‑reactive protein (CRP) level was associated with a lower risk of readmission to the hospital (OR = 0.991; p = 0.03). An increased risk of ventilator therapy was found for patients with chronic heart failure (OR = 6.166; p = 0.02) and sleep apnea syndrome (OR = 6.698; p = 0.003), diabetes (OR = 3.754; p = 0.041) and a long stay in the ICU (OR = 2.018; p = 0.000). CONCLUSIONS Comorbidities in patients with AECOPD were found to be a major risk factor for ICU admission and mechanical ventilation. Elderly patients and patients with prolonged hospital stay showed a higher risk for readmission and mortality. Patients with a low CRP blood level seemed to have a lower risk for rehospitalisation.
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Affiliation(s)
- M Spielmanns
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius Krankenhaus Leverkusen-Opladen, An St. Remigius 29, 51379, Leverkusen, Deutschland. .,Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland.
| | - F Axer
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius Krankenhaus Leverkusen-Opladen, An St. Remigius 29, 51379, Leverkusen, Deutschland
| | - C Nell
- Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland
| | - A R Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland
| | - T Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland
| | - F Magnet
- Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.,Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland
| | - J H Storre
- Universitätsklinikum Freiburg, Freiburg, Deutschland.,Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland
| | - W Windisch
- Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.,Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland
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Glöckl R, Göhl O, Spielmanns M, Taube K, Bock R, Schultz K, Worth H. Stellenwert ambulanter, gerätegestützter Trainingstherapie bei Atemwegs- und Lungenkrankheiten. Pneumologie 2016; 70:446-53. [DOI: 10.1055/s-0042-105898] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungDie körperliche Trainingstherapie gilt als eine der wichtigsten Therapieoptionen für Patienten mit chronischen Atemwegs- und Lungenkrankheiten: Die Effekte des Ausdauer- und Krafttrainings auf Atemnot, körperliche Leistungsfähigkeit und Lebensqualität sind unbestritten. Dennoch wird die Trainingstherapie im ambulanten Bereich durch die Rahmenvereinbarungen der Bundesarbeitsgemeinschaft für Rehabilitation (BAR) limitiert: Nur der in Gruppen angeleitete Lungensport wird über längere Zeiträume von den Kostenträgern finanziert, das gerätegestützte Training bleibt ausgeschlossen, obwohl sich dessen herausragende Effizienz durch zahlreiche randomisiert kontrollierte Studien nachweisen lässt. In diesem Übersichtsartikel werden neben der Methodik und den Effekten auch die aktuellen organisatorischen Strukturen einer ambulanten, gerätegestützten Trainingstherapie für Patienten mit chronischen Atemwegs- und Lungenkrankheiten in Deutschland aufgezeigt und kritisch diskutiert.
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Affiliation(s)
- R. Glöckl
- Schön Klinik Berchtesgadener Land, Fachzentrum Pneumologie, Schönau am Königssee
- Klinikum rechts der Isar, Technische Universität München (TUM), Lehrstuhl für Prävention, Rehabilitation und Sportmedizin, München
| | - O. Göhl
- Rehaklinik Heidelberg Königstuhl
| | - M. Spielmanns
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL) St. Remigius-Krankenhaus Leverkusen
- Faculty of Health, School of Medicine, University of Witten/Herdecke
| | | | - R. Bock
- Lungenpraxis Alstertal, Hamburg
| | - K. Schultz
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie der DRV Bayern Süd, Bad Reichenhall
| | - H. Worth
- Praxis Drs. Bily/Kellermann, Facharztforum Fürth
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Spielmanns M, Gloeckl R, Schmoor C, Windisch W, Storre JH, Boensch M, Kenn K. Effects on pulmonary rehabilitation in patients with COPD or ILD: A retrospective analysis of clinical and functional predictors with particular emphasis on gender. Respir Med 2016; 113:8-14. [PMID: 27021574 DOI: 10.1016/j.rmed.2016.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/11/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND The response of patients in a pulmonary rehabilitation (PR) is essentially good. However, not all patients benefit from PR to the same extent. In this analysis we wanted to identify the impact of gender and other factors on PR outcomes in patients with chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD). METHODS Patients suffering from COPD (n = 1492) or ILD (n = 599), treated during an inpatient PR between 1997 and 2015, were analysed according to the effects of PR on exercise capacity and quality of life with regard to the impact of gender or other predictors by univariate and multivariate analyzes. RESULTS In the group of COPD patients, 30% did not achieve the expected physical performance during the 6-min walk test (28% of female and 32% of male patients). However, the non-responders initially have had a higher 6-min walking distance (6-MWD) (p < 0.001) and both male and female showed a significant lower BODE index (p = 0.025) in the multivariate analysis. In the ILD-group, 37% females and 43% males were classified as non-responders with regard to the 6-MWD. Also in this group, the non-responders initially have had a higher 6-MWD (p < 0.001). All other variables (age, BMI, lung function, blood gases, C-reactive Protein, Haemoglobin or rehabilitation duration) had no influence on the outcome. CONCLUSION Our study supports the positive effects of PR in COPD and ILD patients. In both groups, patients with the biggest limitations benefit most from PR. However, relevant gender differences or other predictors could not be found.
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Affiliation(s)
- M Spielmanns
- Remigius Hospital, Leverkusen, Opladen, Germany; Department of Pneumology, University of Witten/Herdecke, Germany.
| | - R Gloeckl
- Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Prevention, Rehabilitation and Sports Medicine, Klinikum Rechts der Isar, Technische Universität München (TUM), Munich, Germany
| | - C Schmoor
- Clinical Trials Unit, University Medical Center, Freiburg, Germany
| | - W Windisch
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Koeln gGmbH, Germany; Department of Pneumology, University of Witten/Herdecke, Germany
| | - J H Storre
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Koeln gGmbH, Germany; Department of Pneumology, University Hospital, Freiburg, Germany
| | - M Boensch
- Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - K Kenn
- Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Phillips University Marburg, Germany
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Spielmanns M, Glöckl R, Schmoor C, Windisch W, Bönsch M, Kenn K. Pneumologische Rehabilitation bei interstitiellen Lungenkrankheiten: Wer profitiert und welche Rolle spielt das Geschlecht? Pneumologie 2016. [DOI: 10.1055/s-0036-1572183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Spielmanns M, Glöckl R, Schmoor C, Windisch W, Bönsch M, Kenn K. Prädiktoren für den Erfolg oder das Versagen einer pneumologischen Rehabilitation bei COPD unter besonderer Berücksichtigung des Geschlechts. Pneumologie 2016. [DOI: 10.1055/s-0036-1572185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Spielmanns M, Winkler A, Storre JH, Böselt T, Nell C, Koczulla R, Windisch W. Kann eine ambulante pneumologische Rehabilitation die Exacerbationsfrequenz nach AECOPD senken? Pneumologie 2016. [DOI: 10.1055/s-0036-1572258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Spielmanns M, Axer F, Nell C, Koczulla R, Böselt T, Storre JH, Windisch W. Outcomeprädiktoren für hospitalisierte akut exacerbierte COPD-Patienten. Pneumologie 2016. [DOI: 10.1055/s-0036-1572268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Spielmanns M, Winkler A, Priegnitz C, Randerath W. [Preliminary Short-term Results of an All-day Outpatient Pulmonary Rehabilitation Program in an Acute Hospital on Patients with Mild to Very Severe COPD]. REHABILITATION 2015; 54:297-303. [PMID: 26505181 DOI: 10.1055/s-0035-1555910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Positive effects of pulmonary rehabilitation on chronic obstructive pulmonary disease (COPD) are well known, and inpatient rehabilitation programs are the preferred modality in Germany. In this paper, we report on the recent results of a daily outpatient rehabilitation program offered at an acute hospital, the first of this kind in Germany. It is not known whether this kind of rehabilitation is an effective approach. METHODS 32 consecutive COPD patients GOLD-stage II-IV, phenotype B-D (mean 64.5±21.9 years; 18 male, 14 female) completed a rehabilitation program of 19 (15-21) days conducted according to the recommendations of the National Accociation for Rehabilitation. In this prospective observational study, data (walking distance in the 6-MWD, BODE-Index, HADS-, BDI/TDI-, CAT-questionnaire) were collected at the beginning (T1) and at the end (T2) of the program and the results are presented in a pre- vs. post-analysis. RESULTS We found significant positive effects for most of the measured parameters, except for body plethysmography, diffusion capacity and blood gas. Especially the increase in the 6 min walking distance (6-MWD) was remarkable (T1: 485.78±158.24, T2: 527.97±146.75 m, p=0.0212). There were no adverse events or complications. All participants were able to complete the program properly. CONCLUSION Most of the measured parameters in COPD patients with stage II or worse disease improved significantly during the comprehensive outpatient rehabilitation program. A limitation of this study is the small number of cases, and further conclusions can only be made after examining a larger sample. The setting of this rehabilitation program in an acute hospital seems to be meaningful in an organisational and structural sense.
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Affiliation(s)
- M Spielmanns
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius-Krankenhaus Leverkusen und Faculty of Health, School of Medicine, University of Witten/Herdecke
| | - A Winkler
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius-Krankenhaus Leverkusen und Faculty of Health, School of Medicine, University of Witten/Herdecke
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Spielmanns M, Winkler A. Effekte eines ambulanten pneumologischen Rehabilitationsprogramm bei stabilen COPD-Patienten. Pneumologie 2015. [DOI: 10.1055/s-0035-1544672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Spielmanns M, Winkler A, Fuchs-Bergsma C, Baum K. Intervall versus kontinuierliches Ausdauertraining bei COPD-Patienten: eine Studie im Cross-over Design. Pneumologie 2014. [DOI: 10.1055/s-0034-1367836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Spielmanns M, Winkler A, Fuchs-Bergsma C, Baum K. Systematisches Ausdauertraining zeigt einen Ceiling-Effekt bei COPD-Patienten trotz Steigerung der Trainingsintensität. Pneumologie 2014. [DOI: 10.1055/s-0034-1367750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Spielmanns M, Winkler A, Fuchs-Bergsma C, Baum K. Eine Sauerstoffgabe bei nicht-hypoxischen COPD-Patienten im Rahmen eines körperlichen Trainings zeigt keinen zusätzlichen Trainingsgewinn: eine kontrollierte Studie. Pneumologie 2014. [DOI: 10.1055/s-0034-1367835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Spielmanns M, Baum K, Hoffmann U. Effekte eines 12-wöchigen Trainings bei nicht-hypoxischen COPD-Patienten unter Sauerstoffsupplementierung. Pneumologie 2009. [DOI: 10.1055/s-0029-1213805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Spielmanns M, Baum K, Hoffmann U. Effekte eines 12-wöchigen Trainings bei nicht-hypoxischen COPD-Patienten unter Sauerstoffsupplementierung. Pneumologie 2009. [DOI: 10.1055/s-0029-1213855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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