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Çelik Z, Kafa N, Güzel NA, Köktürk N. The effects of physical activity tele-counseling intervention on physical activity, functional performance, and quality of life in post-COVID-19 conditions: a randomized controlled trial. Expert Rev Respir Med 2024:1-11. [PMID: 38829396 DOI: 10.1080/17476348.2024.2363862] [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: 12/16/2023] [Accepted: 05/31/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND This study aims to investigate the effectiveness of tele-counseling to promote physical activity in COVID-19 survivors at the persistent phase. METHODS Twenty-eight participants who suffered from COVID-19 were randomly assigned to intervention and control groups. Physical activity counseling was applied according to the transtheoretical model to the intervention group during 20 sessions. Second assessments were performed 6 weeks after the intervention. The physical activity, functional performance (4-meter gait speed; 4-MGS and 5-repetition Sit-To-Stand; STS test), exercise behavioral change and processes, quality of life, fatigue, mental health, severity of symptoms, and dyspnea were evaluated in groups. RESULTS The baseline demographic and clinical outcomes were similar (p > 0.05) except for physical role limitations and general health perceptions in groups. Five-repetition STS, 4-MGS, activity dyspnea, step counts, sitting time, physical role limitations, Exercise Processes of Change Scale (EPCS) total, and behavioral processes scores except for self-liberation significantly improved in the counseling group. Five-repetition STS, 4-MGS improved while dramatic relief, self reevaluation, self-liberation, and EPCS total scores deteriorated in the control group. CONCLUSIONS The tele-counseling intervention contributes to improving physical activity, functional performance, behavioral change, quality of life, and decreasing common problems related to COVID-19. The results of the tele-counseling intervention are promising in post-COVID-19 conditions. TRIAL REGISTRATION (CLINICALTRIALS.GOV) Registration ID: NCT04853966.
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Affiliation(s)
- Zeliha Çelik
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Nihan Kafa
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Nevin A Güzel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Nurdan Köktürk
- Department of Pulmonary Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
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Lee PA, DuMontier C, Yu W, Ask L, Zhou J, Testa MA, Kim D, Abel G, Travison T, Manor B, Lo OY. Validity and Reliability of a Smartphone Application for Home Measurement of Four-Meter Gait Speed in Older Adults. Bioengineering (Basel) 2024; 11:257. [PMID: 38534531 DOI: 10.3390/bioengineering11030257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/28/2024] Open
Abstract
The four-meter gait speed (4MGS) is a recommended physical performance test in older adults but is challenging to implement clinically. We developed a smartphone application (App) with a four-meter ribbon for remote 4MGS testing at home. This study aimed to assess the validity and reliability of this smartphone App-based assessment of the home 4MGS. We assessed the validity of the smartphone App by comparing it against a gold standard video assessment of the 4MGS conducted by study staff visiting community-dwelling older adults and against the stopwatch-based measurement. Moreover, we assessed the test-retest reliability in two supervised sessions and three additional sessions performed by the participants independently, without staff supervision. The 4MGS measured by the smartphone App was highly correlated with video-based 4MGS (r = 0.94), with minimal differences (mean = 0.07 m/s, ± 1.96 SD = 0.12) across a range of gait speeds. The test-retest reliability for the smartphone App 4MGS was high (ICC values: 0.75 to 0.93). The home 4MGS in older adults can be measured accurately and reliably using a smartphone in the pants pocket and a four-meter strip of ribbon. Leveraging existing technology carried by a significant portion of the older adult population could overcome barriers in busy clinical settings for this well-established objective mobility test.
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Affiliation(s)
- Pei-An Lee
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Clark DuMontier
- VA Boston Healthcare System, Harvard Medical School, Boston, MA 02130, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Wanting Yu
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
| | - Levi Ask
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
| | - Junhong Zhou
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Marcia A Testa
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Dae Kim
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Gregory Abel
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Tom Travison
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Brad Manor
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - On-Yee Lo
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Qiu P, Chen M, Lv S, Xie J, Wu J. The association between walking pace and hand grip strength with the risk of chronic obstructive pulmonary disease: a bidirectional Mendelian randomization study. BMC Pulm Med 2023; 23:450. [PMID: 37986176 PMCID: PMC10658936 DOI: 10.1186/s12890-023-02759-z] [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] [Received: 06/28/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) currently ranks as the third leading cause of mortality worldwide, imposing substantial burdens on societal and individual health. Amongst health research tools, walking pace (WP) and hand grip strength (HGS) are cornerstones, extensively associated with diverse health conditions. However, the intricate interplay between these factors and COPD risk remains ambiguous. This study aims to elucidate the causal association of WP, HGS, with COPD risk through a bidirectional Mendelian randomization (MR) approach. METHODS Bidirectional MR analysis was performed using Genome-wide association study (GWAS) data of European individuals for WP, HGS, and COPD. Inverse Variance Weighted (IVW) served as the primary MR analysis approach. To supplement the IVW findings, four additional MR methods [MR-Egger, weighted median, maximum likelihood, simple median] were used. To assess heterogeneity and pleiotropy, sensitivity analyses were performed. In addition, multivariate MR (MVMR) analysis was used to assess causality after adjustment for potential confounders. RESULTS IVW method results show a significant negative association between WP and COPD risk in both initial (genome-wide threshold, odds ratio (OR) = 0.21, 95% confidence interval (CI) 0.09-0.51, P = 5.06 × 10- 4) and secondary (locus-wide threshold, OR = 0.27, 95%CI: 0.18-0.41, P = 4.88 × 10- 10) MR analysis. The reverse MR analysis suggested that COPD also diminishes WP. Additionally, a causal risk reduction for COPD with right HGS (OR = 0.74, 95% CI: 0.58-0.94, P = 1.44 × 10- 2) was only found in secondary MR analysis. The outcomes of the four additional MR methods also suggested similar causal relationships, and sensitivity analyses endorsed their robustness. Lastly, the MVMR analysis demonstrated that the WP's effect on reducing COPD risk persisted independently of potential confounding variables. CONCLUSION A bidirectional causal relationship exists between typical WP and COPD risk. Conversely, a decrease in right HGS is unidirectionally associated with an increased risk of COPD. The study suggests that WP may serve as a predictive factor for COPD or as a simple evaluative indicator for prognosis.
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Affiliation(s)
- Peng Qiu
- Department of Rehabilitation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingxian Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shuaibing Lv
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Juanjuan Xie
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junyu Wu
- School of Physical Education, Shanghai University of Sport, Shanghai, China.
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Iwakura M, Kawagoshi A, Tamaki A, Oki Y, Oshima Y, Spruit MA. Physical activity measurements in individuals with interstitial lung disease: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:220165. [PMID: 37437911 DOI: 10.1183/16000617.0165-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/11/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Physical activity (PA) measurements are becoming common in interstitial lung disease (ILD); however, standardisation has not been achieved. We aimed to systematically review PA measurement methods, present PA levels and provide practical recommendations on PA measurement in ILD. METHODS We searched four databases up to November 2022 for studies assessing PA in ILD. We collected information about the studies and participants, the methods used to measure PA, and the PA metrics. Studies were scored using 12 items regarding PA measurements to evaluate the reporting quality of activity monitor use. RESULTS In 40 of the included studies, PA was measured using various devices or questionnaires with numerous metrics. Of the 33 studies that utilised activity monitors, a median of five out of 12 items were not reported, with the definition of nonwear time being the most frequently omitted. The meta-analyses showed that the pooled means (95% CI) of steps, time spent in moderate to vigorous PA, total energy expenditure and sedentary time were 5215 (4640-5791) steps·day-1, 82 (58-106) min·day-1, 2130 (1847-2412) kcal·day-1 and 605 (323-887) min·day-1, respectively, with considerable heterogeneity. CONCLUSION The use of activity monitors and questionnaires in ILD lacks consistency. Improvement is required in the reporting quality of PA measurement methods using activity monitors.
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Affiliation(s)
- Masahiro Iwakura
- Department of Rehabilitation, Akita City Hospital, Akita City, Japan
| | | | - Akira Tamaki
- School of Rehabilitation, Hyogo Medical University, Hyogo, Japan
| | - Yutaro Oki
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Yohei Oshima
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Martijn A Spruit
- Department of Research and Development, CIRO, Horn, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+) NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Nakano T, Kimura S, Yamashita T, Yoshimi M, Tao Y, Takata S. Correlation of 4-meter gait speed with clinical indicators of chronic obstructive pulmonary disease. Respir Investig 2021; 59:505-512. [PMID: 33903076 DOI: 10.1016/j.resinv.2021.03.008] [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: 10/14/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Measuring daily physical activity and exercise capacity is recommended in the routine care of patients with chronic obstructive pulmonary disease (COPD). The 4-m gait speed (4mGS) is simple and effective in stratifying patients according to exercise performance, dyspnea, health status, and prognosis. We assessed the reliability of the 4mGS as a clinical marker by examining its association with established clinical indicators among hospitalized patients with COPD. METHODS This retrospective study included 78 patients hospitalized with COPD (mean age: 76.3 ± 0.9 years; males, n = 69) between January 2016 and June 2018 who were assessed using the 4mGS and divided into slow (<0.8 m/s) and normal (≥0.8 m/s) 4mGS groups. Clinical characteristics were compared, including death during the observation period, time to first exacerbation, and long-term oxygen therapy requirement. RESULTS There were strong relationships between 4mGS performance, the 6-min walk test (R = 0.70; p < 0.0001), and the modified Medical Research Council dyspnea scale (R = 0.68; p < 0.0001) among the 78 patients. The slow 4mGS group had a higher frequency of death during the observation period (p = 0.0095) and a greater requirement for long-term oxygen therapy (p = 0.0063). The 4mGS correlated with inspiratory capacity (IC) and IC/total lung capacity ratios, which are respiratory failure indicators. CONCLUSIONS The 4mGS is a simple and easy method of assessing the physical condition as well as estimating the prognosis of patients with COPD, and may serve as a useful marker in home medical treatment or clinical settings.
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Affiliation(s)
- Takako Nakano
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan.
| | - Shinichi Kimura
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Takafumi Yamashita
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Michihiro Yoshimi
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Yoshiaki Tao
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Shohei Takata
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
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Abstract
Lung function testing has undisputed value in the comprehensive assessment and individualized management of chronic obstructive pulmonary disease, a pathologic condition in which a functional abnormality, poorly reversible expiratory airway obstruction, is at the core of its definition. After an overview of the physiologic underpinnings of the disease, the authors outline the role of lung function testing in this disease, including diagnosis, assessment of severity, and indication for and responses to pharmacologic and nonpharmacologic interventions. They discuss the current controversies surrounding test interpretation with these purposes in mind and provide balanced recommendations to optimize their usefulness in different clinical scenarios.
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