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Leshchenko IV, Avdeev SN, Zaytsev AA, Ovcharenko SI. [Chronic bronchitis - new clinical recommendations (main provisions): A review on behalf of the working group for the development and revision of clinical guidelines for chronic bronchitis]. TERAPEVT ARKH 2025; 97:272-278. [PMID: 40327622 DOI: 10.26442/00403660.2025.03.203134] [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: 12/16/2024] [Accepted: 12/16/2024] [Indexed: 05/08/2025]
Abstract
Chronic bronchitis (CB) is one of the most commonly diagnosed non-communicable chronic diseases. At the same time, with such a high incidence of CB registered in the Russian Federation, this pathology requires a balanced approach to the interpretation of clinical and functional indicators and their differentiated approach. The main provisions of the new clinical recommendations on CB, which are reflected in the article, will be useful in the practical work of an internist.
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Affiliation(s)
- I V Leshchenko
- Ural State Medical University
- Ural Research Institute of Phthisiopulmonology - branch of the National Medical Research Center for Phthisiopulmonology and Infectious Diseases
| | - S N Avdeev
- Sechenov First Moscow State Medical University (Sechenov University)
- Research Institute of Pulmonology
| | | | - S I Ovcharenko
- Sechenov First Moscow State Medical University (Sechenov University)
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2
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Zhu C, Cui Z, Liu T, Lou S, Zhou L, Chen J, Zhao R, Wang L, Ou Y, Zou F. Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system. Front Pharmacol 2025; 16:1531514. [PMID: 40144660 PMCID: PMC11937142 DOI: 10.3389/fphar.2025.1531514] [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: 11/20/2024] [Accepted: 02/21/2025] [Indexed: 03/28/2025] Open
Abstract
Background Elexacaftor/Tezacaftor/Ivacaftor (ETI) has demonstrated significant efficacy in enhancing clinical outcomes for patients with cystic fibrosis (CF). Despite this, comprehensive post-marketing assessments of its adverse drug events (ADEs) remain insufficient. This study aims to analyze the ADEs associated with ETI using the U.S. FDA Adverse Event Reporting System (FAERS). Methods We conducted a pharmacovigilance analysis utilizing FAERS data from Q4 2019 to Q3 2024. Reports of ADEs related to ETI were extracted, and disproportionality analyses-including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS)-were employed to evaluate signal strength. Additionally, a time-to-onset (TTO) analysis was performed. Results A total of 28,366 ETI-related ADEs were identified, spanning 27 organ systems. We identified 322 positive signals, with signals consistent with the drug label including headache (702 cases, ROR 2.75), infective pulmonary exacerbation of CF (691 cases, ROR 384.24), rash (538 cases, ROR 2.72), and cough (507 cases, ROR 3.79). Unexpected signals were also noted, such as anxiety (494 cases, ROR 4.16), depression (364 cases, ROR 4.59), insomnia (281 cases ROR 2.83), nephrolithiasis (79 cases, ROR 3.63) and perinatal depression (4 cases, ROR 13.59). The TTO analysis indicated that the median onset of ADEs was 70 days, with 37.08% occurring within the first month. Subgroup analyses revealed that females exhibited a higher reporting rank for mental disorder and constipation, whereas in males, they were insomnia, abdominal pain, and nasopharyngitis. Conclusion This study highlights both recognized and unexpected ADEs associated with ETI, underscoring the necessity for ongoing monitoring, particularly concerning psychiatric conditions. The subgroup analysis suggests a need for personalized treatment strategies to optimize patient care.
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Affiliation(s)
- Chengyu Zhu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhiwei Cui
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Tingting Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Siyu Lou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Linmei Zhou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Junyou Chen
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ruizhen Zhao
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Li Wang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yingyong Ou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Fan Zou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Ficarra S, Kang DW, Wilson RL, Gonzalo-Encabo P, Christopher CN, Normann AJ, Lopez P, Lakićević N, Dieli-Conwright CM. Exercise medicine for individuals diagnosed with Lung Cancer: A systematic review and meta-analysis of health outcomes. Lung Cancer 2025; 201:108413. [PMID: 39983446 DOI: 10.1016/j.lungcan.2025.108413] [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: 12/05/2024] [Revised: 01/26/2025] [Accepted: 01/28/2025] [Indexed: 02/23/2025]
Abstract
Consensus exists regarding the need to provide exercise interventions to individuals diagnosed with lung cancer (LC). Exercise interventions for this populations usually include multidisciplinary approaches, making the attempt to understand the effects of exercise a real challenge. Therefore, we designed a systematic review to identify the effects of exercise interventions among individuals with a LC diagnosis. Following the PRISMA guidelines, studies across 5 different databases were systematically screened. Eligible studies were randomised and non-randomised trials, including individuals with a LC diagnosis, administering exercise-only interventions. Three-level meta-analyses were performed for cardiorespiratory fitness, strength, physical function, anxiety, depression, and health-related quality of life. Differences between exercise types were also explored. The Cochrane Risk of Bias (RoB) II tool for randomised controlled trials and the RoB in non-randomised studies - of interventions were used to assess study quality. A total of 36,304 records were screened and 13 studies, including 547 LC survivors, were considered eligible. Randomised and non-randomised trials were mainly judged as "some concern" and at "serious" RoB, respectively. Meta-analyses reported significant improvements on physical function among exercise groups compared to control (ES = 0.62; 95 % CI: 0.10 to 1.15; p = 0.03), and no significant changes for all other variables. There is moderate evidence that exercise interventions appear to be an effective tool to improve physical function among individuals diagnosed with LC. Further studies are still needed to determine exercise prescription effectiveness on health outcomes, differences across exercise types and enhance individualized interventions.
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Affiliation(s)
- Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, Department of Psychology Educational Science and Human Movement, University of Palermo, Palermo, Italy; 2022 OACCUs Project, co-funded by the European Union, UK; Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Rebekah L Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Paola Gonzalo-Encabo
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain
| | - Cami N Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Amber J Normann
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Department of Health Sciences, Boston University, Boston, MA, United States
| | - Pedro Lopez
- Grupo de Pesquisa em Exercício para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil; Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia
| | - Nemanja Lakićević
- Sport and Exercise Sciences Research Unit, Department of Psychology Educational Science and Human Movement, University of Palermo, Palermo, Italy; 2022 OACCUs Project, co-funded by the European Union, UK; Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russia; Federal Scientific Center of Psychological and Interdisciplinary Research, Moscow, Russia
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Chukwu SC, Egbumike CJ, Ojukwu CP, Uchenwoke C, Igwe ES, Ativie NR, Okemmuo AJ, Chukwu NP, Ezeugwu UA, Ikele CN, Uduonu EM. Effects of Diaphragmatic Breathing Exercise on Respiratory Functions and Vocal Sustenance in Apparently Healthy Vocalists. J Voice 2025; 39:564.e37-564.e44. [PMID: 36333216 DOI: 10.1016/j.jvoice.2022.09.025] [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: 08/15/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Effective vocalization is dependent on breathing efficiency. Previous studies have reported the efficacy of Diaphragmatic Breathing Exercise (DBE) on the respiratory muscles and breath control of vocalists. There is a paucity of data on the effects of DBE on their vocal sustenance (VS), which is determined as Maximum Phonation Time (MPT). No known published study has considered physiotherapy as influencing voice dynamics amongst vocalists; evaluated the relationship between respiratory functions (Forced Vital Capacity - FVC, Forced Expiratory Volume in one second - FEV1, FEV1/FVC, and Peak Expiratory Flow - PEF) and VS in apparently healthy vocalists. Moreover, literature on the benefits of DBE to vocalists has not considered explicitly this aspect of vocalization skill, VS. METHODS This is a pre-test - post-test experimental study involving a total of 37 participants (17 males and 20 females) selected by purposive and convenience sampling techniques. The subjects were grouped into DBE and control groups. Spirobank MIR spirometer was used to assess the respiratory function of the singers, while a stopwatch and keyboard were used in assessing the MPT. Statistical analysis was done with SPSS version 21.0. Alpha level set at 0.05. RESULTS Significant improvement was found in respiratory functions (FVC, FEV1, FEV1/FVC, PEF) of the DBE group when pre- and post-test results were compared. The DBE and control groups differed significantly. Respiratory values correlated significantly with the MPT values (FVC - r[p] - 0.416[0.011]; FEV1 - r[p] - 0.416[0.010]; PEF - r[p] - 0.566[0.000]), except for FEV1/FVC - r(p) - 0.248(0.138). Voice category did not correlate with respiratory parameters or MPT. While male singers showed more changes in respiratory function the female singers showed more improvement in MPT. CONCLUSION AND RECOMMENDATION DBE can improve respiration and VS (increased MPT). Therefore, it can be recommended for vocalists, and Physiotherapy can be relevant in trainings to improve vocal dynamics.
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Affiliation(s)
| | - Chukwuenyegom Joseph Egbumike
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria; Department of Physiotherapy, Evangel University, Akaeze, Ebonyi State, Nigeria.
| | - Chidiebele P Ojukwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chigozie Uchenwoke
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Emeka S Igwe
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Nkechi R Ativie
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Adaora J Okemmuo
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Nkem P Chukwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Uchechukwu A Ezeugwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chioma N Ikele
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ekezie M Uduonu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
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Kim C, Choi HE, Rhee CK, Lee JH, Oh JH, Song JH. Prognostic Factors for Responders of Home-Based Pulmonary Rehabilitation-Secondary Analysis of a Randomized Controlled Trial. Healthcare (Basel) 2025; 13:308. [PMID: 39942497 PMCID: PMC11817295 DOI: 10.3390/healthcare13030308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Revised: 01/27/2025] [Accepted: 01/29/2025] [Indexed: 02/16/2025] Open
Abstract
BACKGROUND Home-based pulmonary rehabilitation (PR) is an effective alternative to center-based PR. However, not all participants exhibit sufficient therapeutic improvement, highlighting the need to identify appropriate candidates to maximize cost-effectiveness. This study aimed to identify the factors associated with favorable outcomes in home-based PR, focusing on the role of digital therapeutics (DTx). METHODS This secondary analysis used data from a randomized controlled trial. Participants with chronic respiratory disease (CRD) were divided into responders and non-responders based on a change in 6 min walk distance (6MWD) and patient-reported outcome measures (PROM) representing dyspnea and health-related quality of life. Factors such as baseline 6MWD, DTx use, and pulmonary function were analyzed for their predictive value in improving 6MWD and PROM scores. RESULTS Responders, particularly those using DTx, showed significantly greater improvements in 6MWD than non-responders. Participants with a baseline 6MWD under 500 m demonstrated a higher likelihood of exceeding the minimum clinically important difference in 6MWD. DTx use strongly predicted improvements in both 6MWD and PROM scores. The baseline diffusing capacity of the lungs for carbon monoxide was also a significant factor influencing improvements in the modified Medical Research Council scale. CONCLUSIONS Responders to 8-week program of home-based PR exhibited a relatively lower baseline health status. Encouraging participants with poorer baseline health could improve adherence to PR and enhance cost-effectiveness. Additionally, improvements in 6MWD and PROM scores were associated with the use of DTx. Considering the functions of DTx, proper supervision for home-based exercise may be crucial for achieving optimal outcomes.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea;
| | - Hee-Eun Choi
- Department of Physical Medicine and Rehabilitation, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea;
- Share and Service Inc., Busan 48002, Republic of Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 02812, Republic of Korea;
| | - Jae Ha Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea;
| | - Ju Hyun Oh
- Department of Pulmonary and Critical Care Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea;
| | - Jun Hyeong Song
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea;
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Paraskeva M, Gulline H, West S, Walsh L, Tarrant B, Hatzikiriakidis K, Morris H, Ayton D. 'You Can't Muck Around With Transplant': Young People's Experiences of Clinical Care Following Lung Transplant. Health Expect 2025; 28:e70156. [PMID: 39876587 PMCID: PMC11775388 DOI: 10.1111/hex.70156] [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: 09/23/2024] [Revised: 12/14/2024] [Accepted: 12/29/2024] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND Lung transplantation improves survival and quality of life in young people with end-stage lung disease. Few studies have investigated the clinical care experiences of young people after lung transplantation. DESIGN This qualitative study aimed to explore the experiences of young people who underwent lung transplantation. Semi-structured interviews were conducted with 16 lung transplant recipients (< 25 years at transplant). Interviews were analysed to identify themes and categorize and describe the experience of young lung transplant recipients. RESULTS The themes that emerged were (1) Hope and spectre: The transplant dilemma; (2) Information delivery and comprehension; (3) Independence and navigating care; and (4) Continuity and youth-appropriate care. Findings suggest that young people have distinct care needs that consider the many parallel life transitions that occur in addition to transplantation. They value consistent and familiar teams, which nurture autonomy and independence in the context of post-transplant survivorship and highlight the importance of feeling that they can relate to the healthcare process. CONCLUSION The results highlight key areas where adolescent lung transplant recipients can be supported by clinicians, enabling the development of youth-friendly services that cater to this group's healthcare and psychosocial needs. PATIENT OR PUBLIC CONTRIBUTION Sixteen lung transplant recipients participated in the study by completing a semi-structured interview. Two additional lung transplant recipients who received lung transplants as adolescents and one parent of an adolescent lung transplant recipient participated in a Project Advisory Group (PAG) with six clinicians representing paediatric, adolescent, and adult healthcare experience. They provided advice on research design including the development and revision of the interview guide and recruitment methods. They additionally provided feedback on the preliminary findings and outline of the manuscript. A summary of results was presented to the PAG who in conjunction with the writing group developed a list of recommendations based on the themes identified and the tenets of youth-appropriate care as set out by the World Health Organization. One lung transplant recipient was an author on the manuscript contributing to its writing and review before submission. The clinicians who participated in the PAG did not have direct healthcare relationships with the study participants.
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Affiliation(s)
- Miranda Paraskeva
- Department of Allergy, Immunology, and Respiratory MedicineAlfred HospitalMonash UniversityMelbourneAustralia
- Central Clinical SchoolFaculty of Medicine, Nursing, and Health SciencesMonash UniversityMelbourneAustralia
| | - Hannah Gulline
- Health and Social Care UnitSchool of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health SciencesMonash UniversityMelbourneAustralia
| | - Simone West
- Department of Allergy, Immunology, and Respiratory MedicineAlfred HospitalMonash UniversityMelbourneAustralia
- Department of Occupational TherapyAlfred HospitalMelbourneAustralia
| | - Louisa Walsh
- Department of Nursing and Allied HealthCentre for Health Communication and ParticipationSwinburne University of Technology, La Trobe UniversityMelbourneAustralia
| | - Ben Tarrant
- Department of PhysiotherapySt Vincent's HospitalMelbourneAustralia
| | - Kostas Hatzikiriakidis
- Health and Social Care UnitSchool of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health SciencesMonash UniversityMelbourneAustralia
| | - Heather Morris
- Health and Social Care UnitSchool of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health SciencesMonash UniversityMelbourneAustralia
| | - Darshini Ayton
- Health and Social Care UnitSchool of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health SciencesMonash UniversityMelbourneAustralia
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Salazar JJ, Mirza FT, Uzzaman MN, Shunmugam RH, Shazana NZ, Pinnock H, Hirani N, Rabinovich RA. Characteristics of pulmonary rehabilitation programs and their effects on exercise capacity and health related quality of life (HRQoL) in patients with interstitial lung disease: A systematic review and meta-analysis. Respir Med 2025; 237:107936. [PMID: 39756486 DOI: 10.1016/j.rmed.2024.107936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 12/05/2024] [Accepted: 12/30/2024] [Indexed: 01/07/2025]
Abstract
BACKGROUND Interstitial Lung Disease (ILD) is characterized by dyspnoea, reduced exercise capacity and poor health related quality of life (HRQoL). The evidence to support the benefits of pulmonary rehabilitation (PR) on exercise capacity (EC) and HRQoL in this population is still limited. We aimed to determine the effect of the different PR components on exercise capacity and HRQoL in patients with ILD. METHODS We searched five databases (January 1990 to August 2024) using Population: ILD patients; Intervention: PR; Comparison: no PR; Outcomes: exercise capacity (e.g., 6-min walk test [6MWT] and HRQoL (e.g., St George's respiratory questionnaire [SGRQ]); Study type: randomised controlled trials (RCT). We used Cochrane risk-of-bias tool and GRADE to rate the quality of the evidence. FINDINGS We identified 11 RCTs (476 ILD patients; 8 countries). 10 studies provided data for exercise capacity (6MWD) and 7 studies for HRQoL (SGRQ). Both 6MWD and SGRQ improved ≥ their respective mínimum clinically-important difference of 45m and 7 units respectively, in studies where PR programme was i) >8 weeks (n = 5) [6MWD: MD 58m, 95 % CI 37 to 79, p < 0.00001; SGRQ: MD -9.7, 95 % CI -12.6 to -6.7, p < 0.00001], ii) fully supervised [6MWD (n = 5): MD 53.6m, 95 % CI 39 to 68, p < 0.00001; SGRQ (n = 2): MD -9.38, 95 % CI -12.93 to -5.84, p < 0.00001] and iii) incorporated high-intensity interval training (HIIT) (n = 2) [6MWD: MD 77m, 95 % CI 45 to 109, p < 0.00001; SGRQ: MD -10.3, 95 % CI -13.7 to -6.9, p < 0.00001] INTERPRETATION: PR programs of >8 weeks, fully supervised and incorporated HIIT had a better clinical impact on EC and HRQoL.
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Affiliation(s)
- Jaime Jiménez Salazar
- CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
| | - Fatim Tahirah Mirza
- Centre for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia.
| | - Md Nazim Uzzaman
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
| | - Ranita Hisham Shunmugam
- Department of Library & Information Science, Faculty of Arts & Social Sciences, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Nik Zawani Shazana
- Rehabilitation Department, KPJ Bandar Dato' Onn Specialist Hospital, Bandar Dato' Onn, Malaysia.
| | - Hilary Pinnock
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom.
| | - Nikhil Hirani
- CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
| | - Roberto A Rabinovich
- CIR Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
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Lee DK, Choi JS, Choi SJ, Choi MH, Hong M. Classification of Chronic Obstructive Pulmonary Disease (COPD) Through Respiratory Pattern Analysis. Diagnostics (Basel) 2025; 15:313. [PMID: 39941243 PMCID: PMC11817006 DOI: 10.3390/diagnostics15030313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/23/2025] [Accepted: 01/27/2025] [Indexed: 02/16/2025] Open
Abstract
Background: This study proposes a classification system for predicting chronic obstructive pulmonary disease (COPD) patients and non-patients based on image and text data. Method: This study measured the respiratory volume based on thermal images, stored the respiratory data, and derived features related to respiratory patterns, including the total respiratory volume, average distance between expirations, average distance between inspirations, and total respiratory rate. The data for each feature were stored in text format. The four features saved as text were scaled using Z-score normalization and expressed as scores through weighted summation. These scores were compared to a threshold based on the ROC curve values, classifying participants as patients if the score exceeded the threshold and as non-patients if it fell below. Results: The proposed method achieved an accuracy of 82.5%. To validate the proposed approach, precision, recall, and F1-score were utilized, confirming the high classification performance of the model. The results of this study demonstrate the potential for future applications in non-contact medical examinations and diagnoses of respiratory diseases.
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Affiliation(s)
- Do-Kyeong Lee
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea;
| | - Jae-Sung Choi
- Department of Internal Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea;
| | - Seong-Jun Choi
- Department of Otolaryngology-Head and Neck Surgery, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea;
| | - Min-Hyung Choi
- Department of Computer Science, Saint Louis University, Louis MO 63103, USA
| | - Min Hong
- Department of Computer Software Engineering, Soonchunhyang University, Asan 31538, Republic of Korea
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Stoustrup AL, Thomsen LP, Andreasen J, Palsson TS, Weinreich UM. Cluster randomised controlled trial on the effects of long-term home-based exercise for patients with chronic obstructive pulmonary disease with recent exacerbation: research protocol of the COPDtoParis Project. BMJ Open Respir Res 2025; 12:e002573. [PMID: 39832888 PMCID: PMC11751790 DOI: 10.1136/bmjresp-2024-002573] [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: 05/15/2024] [Accepted: 12/06/2024] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a highly prevalent respiratory disease associated with significant health decline and economic burdens. Pulmonary rehabilitation is an effective intervention, but securing adherence to exercise is difficult, particularly for frail and disabled patients, challenged by leaving their home. Home-based exercise is an emerging alternative for persons with COPD, but long-term adherence is unclear. This study aims to investigate the effects, experiences and acceptability of long-term home-based cycling for patients with COPD post exacerbation. METHODS AND ANALYSES This cluster randomised controlled trial will recruit hospitalised patients with COPD following hospitalisation following exacerbation of COPD. Participants will be referred to acute rehabilitation for 8 weeks at discharge. After rehabilitation, participants are randomised in clusters of five into 1 year of home-based cycling with the goal of cycling from Aalborg to Paris, or into the control group, who will receive standard care. Data will be collected at baseline, postrehabilitation/intervention initiation, at 6 and 12 months. Primary outcome is physical performance, while secondary outcomes include daily activity levels, lung function, mobility, frailty, symptom severity, health-related quality of life, survival rates and readmissions. A qualitative substudy will uncover experiences from participants. Daily activity levels will be measured using leg-mounted triaxial accelerometers. Other parameters will be tested with physical tests, questionnaires and interviews. The study aims to include 50 patients, with 25 participants in each group. A cost-effectiveness analysis will assess the impact on disease prevention and hospitalisation. ETHICS AND DISSEMINATION This study, approved by The North Denmark Region Committee on Health Research Ethics (N-20230008) and compliant with the Helsinki Declaration, includes annual safety and progress reporting of potential adverse events. Results will be disseminated through peer-reviewed publications, conference presentations and community outreach to ensure accessibility to participants, healthcare professionals and the public. TRIAL REGISTRATION NUMBER NCT06235502 and Northern Jutland trial register (F2023-066).
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Affiliation(s)
- Anna Lei Stoustrup
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, The Faculty of Medicine, Aalborg, Denmark
| | | | - Jane Andreasen
- Public Health and Epidemiology Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Aalborg Health and Rehabilitation Center, Aalborg, Aalborg Municipality, Denmark
- Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thorvaldur S Palsson
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Tamburlani M, Cuscito R, D'Angelo A, Galeoto G, Papi L, Ruotolo I, Santini F, Servadio A, Tirelli E, Sellitto G. Downhill: a new rehabilitation frontier. A systematic review of the literature. Monaldi Arch Chest Dis 2025. [PMID: 39821158 DOI: 10.4081/monaldi.2025.3071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 11/11/2024] [Indexed: 01/19/2025] Open
Abstract
In the last few years, we have seen the gradual spread of a new treadmill training modality, which involves walking not on the flat but downhill, also known as "downhill". This review aims to qualitatively assess the efficacy of downhill treatment on different patient populations and outline treatment routes for future efficacy studies. We searched five different databases: MEDLINE, SCOPUS, Web of Science, PEDro, and LILACS for studies to include. Only randomized controlled trials (RCTs) published in English were considered. PEDro scales and Risk of Bias 2 (RoB 2) assessment were used to evaluate the risk of bias. Forty-one RCTs were included, and three articles remained to be analyzed; the included studies showed 110 participants for three RCTs; of these, two were performed on patients diagnosed with chronic obstructive pulmonary disease (COPD), while one was for treating people with multiple sclerosis (MS). The outcome measures used in the studies were the pulmonary function test, the cardiopulmonary exercise test, the 6-Minute Walking Test, and the St. George Respiratory Questionnaire. In patients diagnosed with COPD, downhill training appears effective on functional capacity and symptoms of dyspnea and fatigue, while in people with MS, it increases strength and activity performance when compared to other walking training modalities. RoB 2 tool shows good methodological quality for all studies included in the review; when evaluated with the PEDro scale, all presented a score of 8. Downhill could be such an effective, safe, and feasible eccentric training modality that it can be considered a new rehabilitation strategy that could be implemented for patients with low exercise tolerance.
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Affiliation(s)
| | | | | | | | | | - Ilaria Ruotolo
- Department of Human Neurosciences, Sapienza University, Rome
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11
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Allam NM, Badawy MM, Elimy DA. Effect of Pilates exercises on pulmonary function, respiratory muscle strength, and functional capacity in patients with inhalation injury after flame thermal burn: A prospective randomized controlled trial. Burns 2024; 50:107284. [PMID: 39423714 DOI: 10.1016/j.burns.2024.10.005] [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: 06/07/2024] [Revised: 09/23/2024] [Accepted: 10/05/2024] [Indexed: 10/21/2024]
Abstract
BACKGROUND Inhalation injury is an acute respiratory tract injury that occurrs by inhalation of smoke, toxic gases, or steam. Early management is needed to reduce its mortality and morbidity. The purpose of this study was to ascertain whether Pilates training could help burn patients with inhalation injury after flame thermal burn in increasing pulmonary function, respiratory muscle strength, and functional ability. METHODS In this prospective, randomized, controlled trial, sixty participants (26 males and 34 females) with inhalation injury and deep partial-thickness flame burns of 30-40 % total body surface area (TBSA) were randomized in blocks of four, with a 1:1 allocation ratio into two groups: Group A (Pilates Group); received Pilates training plus conventional physical therapy program, and Group B (Control Group); received conventional physical therapy program only. This study was conducted at the Faculty of Physical Therapy's outpatient clinic, Cairo University, 3 sessions/week for 12 weeks. The primary outcome measure was the forced vital capacity (FVC) measured by a spirometer, while the secondary outcome measures were peak expiratory flow rate (PEFR), forced expiratory volume in 1 s (FEV1), FEV1/FVC% assessed by a spirometer, strength of respiratory muscles (maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) assessed by the digital manovacuometer, and the functional capacity evaluated by 6-Minute Walk Test (6-MWT). RESULTS A two-way mixed-design MANOVA was used to analyze the results within and between groups. There were no significant differences in demographic data between groups (P > 0.05). There were significant differences in all variables after treatment in group A compared with group B; FVC (95 % CI: 0.38, 1.13) (P = 0.001), FEV1 (95 % CI: 0.39, 0.97) (P = 0.001), FEV1/FVC % (95 % CI: 1.90, 17.19) (P = 0.02), PEFR (95 % CI: 0.47, 0.99) (P = 0.001), MIP (95 % CI: 5.12, 11.44) (P = 0.001), MEP (95 % CI: 2.57, 8.24) (P = 0.001), 6-MWT (95 % CI: 27.22, 54.96) (P = 0.001), FVC (% predicted) (95 % CI: 3.58, 12.58) (P = 0.001), FEV1 (% predicted) (95 % CI: 1.21, 11.11) (P = 0.02), PEFR (% predicted) (95 % CI: 1.33, 10.83) (P = 0.01), MIP (% predicted) (95 % CI: 2.26, 11.72) (P = 0.001) and MEP (% predicted) (95 % CI: 1.33, 10.37) (P = 0.01). CONCLUSION The current study demonstrated that a Pilates exercise program in addition to a traditional physical therapy program for 12 weeks significantly improved the pulmonary function (FVC, FEV1, PEFR and FEV1/FEV), strength of respiratory muscles (MIP and MEP), and functional capacity (6-MWT) in patients with inhalation injury after flame burns. These results underscore the importance of including Pilates exercises in the rehabilitation plan for burn patients with inhalation injury. Future studies are needed to evaluate the effect of Pilates exercises on other degrees and TBSA of burn, long-term follow up, and to measure cardiopulmonary parameters.
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Affiliation(s)
- Nesma M Allam
- Department of physical therapy for surgery, Faculty of Physical Therapy, Cairo University, Egypt; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Saudi Arabia.
| | - Manar M Badawy
- Department of Physical Therapy, Faculty of Allied Medical Sciences, Philadelphia University, Jordon
| | - Doaa A Elimy
- Department of Physical Therapy for Basic Science, Faculty of Physical Therapy, Cairo University, Egypt; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Najran University, Saudi Arabia
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Vitacca M, Paneroni M. Pulmonary rehabilitation guidelines for COPD; where do we go from here? Expert Rev Respir Med 2024; 18:831-833. [PMID: 39412092 DOI: 10.1080/17476348.2024.2418512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 10/15/2024] [Indexed: 10/20/2024]
Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Lumezzane, Brescia, Italy
| | - Mara Paneroni
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Lumezzane, Brescia, Italy
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Bhat A, Lee AL, Carlin BW. History of Pulmonary Rehabilitation: An International Perspective. J Cardiopulm Rehabil Prev 2024; 44:387-390. [PMID: 39298622 DOI: 10.1097/hcr.0000000000000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Affiliation(s)
- Anup Bhat
- Author Affiliations: Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India (Mr Bhat); Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia (Dr Lee); Institute for Breathing and Sleep, Heidelberg, Victoria, Australia (Dr Lee); and Sleep Medicine and Lung Health Consultants, Pittsburgh, Pennsylvania (Dr Carlin)
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Zhang X, Igor B, Elena D, Olga R, Glazachev O. Prevalence of occupational hypersensitivity pneumonitis: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3891-3908. [PMID: 38544315 DOI: 10.1080/09603123.2024.2333021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/16/2024] [Indexed: 10/19/2024]
Abstract
In this meta-analysis, we aimed to evaluate the prevalence of occupational hypersensitivity pneumonitis (OHP) among different occupations globally. Our search was conducted on MEDLINE via PubMed, Scopus, Web of Science, and Cochrane CENTRAL from inception to September 2023. Eligible studies were observational in nature and focused on several specific occupations. A total of 46 articles were included (n = 2,826,420 participants). The overall prevalence of OHP was found to be 4.2% (95% CI: 2.1% to 8.0%), but this varied significantly based on occupation and geographic location. Printers had the highest OHP prevalence at 57.14%, followed by tobacco workers (26.32%), and water-related workers (24.10%). South America showed the highest prevalence of 16.71%, compared to Asia (15.19%), and North America (8.52%). Significant variations in OHP prevalence by occupation and region were found, with the highest rates in printers and tobacco workers. Age and smoking were identified as contributing factors to the prevalence variability.
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Affiliation(s)
- Xinliang Zhang
- Department of Normal Physiology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Bukhtiyarov Igor
- Department of Normal Physiology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Occupational Medicine, Izmerov Research Institute of Occupational Health, Moscow, Russia
| | - Dudnik Elena
- Department of Normal Physiology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Rumyantseva Olga
- Department of Occupational Medicine, Izmerov Research Institute of Occupational Health, Moscow, Russia
| | - Oleg Glazachev
- Department of Normal Physiology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Shiraishi M, Higashimoto Y, Sugiya R, Mizusawa H, Takeda Y, Noguchi M, Nishiyama O, Yamazaki R, Kudo S, Kimura T, Matsumoto H. Enhanced diaphragm excursion and exercise tolerance in COPD patients through inspiratory muscle training after standardised pulmonary rehabilitation: randomised controlled trial. ERJ Open Res 2024; 10:00035-2024. [PMID: 39588075 PMCID: PMC11587166 DOI: 10.1183/23120541.00035-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/27/2024] [Indexed: 11/27/2024] Open
Abstract
Objective Inspiratory muscle training (IMT) is used to improve inspiratory muscle strength in patients with COPD. However, the effect of IMT on diaphragmatic function has not yet been thoroughly evaluated. This study aimed to evaluate the effect of IMT on maximum diaphragmatic excursion (DEmax) using ultrasonography in patients with COPD. Methods This was a single-centre, randomised, prospective, parallel-group, unblinded controlled trial involving 38 participants with stable COPD. Participants underwent a standardised 12-week pulmonary rehabilitation (PR) programme followed by a 12-week IMT programme, consisting of home-based IMT and low-frequency outpatient PR sessions supervised by physiotherapists (once every 2 weeks), versus low-frequency outpatient PR alone as a control. The DEmax and exercise tolerance were measured. Results Out of the 38 patients initially enrolled in the PR programme, 33 successfully completed it and were subsequently randomised to the IMT programme. Finally, 15 (94%) and 14 (88%) patients from the IMT and control groups, respectively, completed the study. Following the IMT programme, DEmax increased in the IMT group (mean±sd 50.1±7.6 mm to 60.6±8.0 mm, p<0.001), but not in the control group (47.4±7.9 mm to 46.9±8.3 mm, p=0.10). Changes in DEmax and exercise tolerance (peak oxygen uptake) were greater in the IMT group than in the control group (both p<0.01). Conclusions IMT following the PR programme improved DEmax and exercise tolerance. Therefore, DEmax may be an important outcome of IMT.
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Affiliation(s)
- Masashi Shiraishi
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Yuji Higashimoto
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Ryuji Sugiya
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Hiroki Mizusawa
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Yu Takeda
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Masaya Noguchi
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Osamu Nishiyama
- Department of Respiratory Medicine and Allergology, Kindai University School of Medicine, Osaka, Japan
| | - Ryo Yamazaki
- Department of Respiratory Medicine and Allergology, Kindai University School of Medicine, Osaka, Japan
| | - Shintarou Kudo
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Tamotsu Kimura
- Department of Rehabilitation Medicine, Kindai University School of Medicine, Osaka, Japan
| | - Hisako Matsumoto
- Department of Respiratory Medicine and Allergology, Kindai University School of Medicine, Osaka, Japan
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Munawar M, Wickerson L, Gottesman C, Braun A, Nourouzpour S, de Perrot M, Singer LG, Keshavjee S, Granton J, Rozenberg D. Pulmonary rehabilitation in lung transplant candidates with pulmonary arterial hypertension. Respir Med 2024; 234:107816. [PMID: 39321999 DOI: 10.1016/j.rmed.2024.107816] [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: 06/05/2024] [Revised: 09/20/2024] [Accepted: 09/21/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Pulmonary rehabilitation (PR) guidelines support the efficacy and safety of supervised exercise training in mild-moderate pulmonary arterial hypertension (PAH). However, the exercise training response and safety of PR in PAH lung transplant (LTx) candidates has not been described. OBJECTIVES (1) characterize the clinical characteristics and illness trajectory of adult patients with severe PAH listed for LTx and participating in PR; (2) evaluate the change in exercise capacity, aerobic and resistance training volumes; (3) assess PR safety. METHODS Single-centre retrospective cohort study of PAH LTx candidates listed January 2014-December 2018 attending a supervised, facility-based outpatient program three times per week. Functional capacity was evaluated using 6-min walk distance (6MWD). Aerobic and muscle training volumes were evaluated with paired comparisons. RESULTS 40 PAH LTx candidates (age 50 ± 12 years, 73% females, mean pulmonary artery pressure 53 ± 16 mmHg) were included. The median listing duration was 91 [IQR 43-232] days. Sixteen patients (40%) had ≥1 admission pre-transplant. Nine patients (56%) were discharged home and resumed outpatient PR. Baseline 6MWD was 330 ± 119 metres (n = 40) with the final 6MWD pre-LTx increasing by 18 metres 95% CI (-18 to 56), p-value = 0.31, n = 25) over a median duration of 225 [IQR 70-311] days. Modest gains were observed in aerobic and resistance training volumes in PR with no adverse safety events. CONCLUSION Despite progressive and severe disease in PAH LTx candidates, patients safely participated in PR and maintained exercise capacity. Given frequent admissions, physiotherapy during hospitalization should focus on preserving functional capacity and facilitating re-integration into outpatient PR post-discharge.
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Affiliation(s)
- Maha Munawar
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Lisa Wickerson
- Physical Therapy, Lung Transplant Program, University of Toronto, University Health Network, Canada; Toronto General Hospital Research Institute, University Health Network, Canada
| | - Chaya Gottesman
- Physical Therapy, Lung Transplant Program, University of Toronto, University Health Network, Canada
| | - Aislinn Braun
- Physical Therapy, Lung Transplant Program, University of Toronto, University Health Network, Canada
| | - Sahar Nourouzpour
- Toronto General Hospital Research Institute, University Health Network, Canada
| | - Marc de Perrot
- Temerty Faculty of Medicine, University of Toronto, Canada; Thoracic Surgery and Chronic Thromboembolic Pulmonary Hypertension, University Health Network, Canada; Thoracic Surgery and Lung Transplantation, University Health Network, Canada
| | - Lianne G Singer
- Toronto General Hospital Research Institute, University Health Network, Canada; Temerty Faculty of Medicine, University of Toronto, Canada; Respirology and Lung Transplantation, University Health Network, Canada
| | - Shaf Keshavjee
- Temerty Faculty of Medicine, University of Toronto, Canada; Thoracic Surgery and Lung Transplantation, University Health Network, Canada
| | - John Granton
- Temerty Faculty of Medicine, University of Toronto, Canada; Respirology, Pulmonary Hypertension, University Health Network, Canada
| | - Dmitry Rozenberg
- Toronto General Hospital Research Institute, University Health Network, Canada; Temerty Faculty of Medicine, University of Toronto, Canada; Respirology and Lung Transplantation, University Health Network, Canada.
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17
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Martínez-Pozas O, Corbellini C, Cuenca-Zaldívar JN, Meléndez-Oliva É, Sinatti P, Sánchez Romero EA. Effectiveness of telerehabilitation versus face-to-face pulmonary rehabilitation on physical function and quality of life in people with post COVID-19 condition: a systematic review and network meta-analysis. Eur J Phys Rehabil Med 2024; 60:868-877. [PMID: 39235257 PMCID: PMC11561472 DOI: 10.23736/s1973-9087.24.08540-x] [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: 04/04/2024] [Revised: 06/07/2024] [Accepted: 07/10/2024] [Indexed: 09/06/2024]
Abstract
INTRODUCTION Post COVID-19 condition (PCC) is characterized by the persistence of symptoms associated with COVID-19 infection for more than 12 weeks, with worsening quality of life and physical function deconditioning being among the most commonly reported persistent symptoms. Pulmonary rehabilitation has emerged as a safe and viable option for these patients. Administered either face-to-face (FTF) or telemedicine (TL), it has been shown to improve symptoms associated with PCC. However, little is known about which approach is best for this population. Therefore, we conducted a systematic review and network meta-analysis on the efficacy of FTF versus TL compared to usual care in improving physical function and quality of life (physical and mental) in patients with PCC. EVIDENCE ACQUISITION A systematic search of PubMed, Cochrane Library, and Web of Science was performed from 2020 to January 5th, 2024. Two independent reviewers performed study selection, data extraction, and risk of bias assessment; this selection included only randomized controlled trials. A network meta-analysis was performed to compare the effects of FTF and TL with usual care. Multivariate and univariate analysis were performed to evaluate the best intervention. EVIDENCE SYNTHESIS Data were extracted from 10 studies, five of which were treated with FTF and five of which were TL, involving 765 adults with PCC, ranging in age from 22 to 66 years. Interventions consisted of isolated or combined exercises (aerobic, resistance, breathing) and lasted between three and ten weeks in most of the included studies. Multivariate analysis found that FTF produced significant differences compared to TL or usual care with moderate quality of evidence. Univariate analysis found that significant differences were only found for physical function and mental domain of quality of life for TL vs. usual care, with moderate quality of evidence. CONCLUSIONS This study supports the use of FTF as a therapy to improve physical function and quality of life in patients with PCC. However, in the absence of differences between FTF and TL in the univariate model for any of the outcomes studied, the choice of the form of pulmonary rehabilitation administration should be individualized. Future studies should compare FTF with TL directly to clarify which is the best approach.
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Affiliation(s)
- Oliver Martínez-Pozas
- International Postgraduate School, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Spain -
- Physiotherapy and Orofacial Pain Working Group, Spanish Society of Craniomandibular Dysfunction and Orofacial Pain (SEDCYDO), Madrid, Spain -
- Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, Spain -
- Cognitive Neuroscience, Pain, and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain -
| | - Camilo Corbellini
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health and Sport Sciences Research Institute A.s.b.l., Differdange, Luxembourg
| | - Juan N Cuenca-Zaldívar
- Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, Spain
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Fisioterapia, Faculdad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), Majadahonda, Spain
- Physical Therapy Unit, Primary Health Care Center "El Abajón", Las Rozas de Madrid, Spain
| | - Érika Meléndez-Oliva
- Physiotherapy and Orofacial Pain Working Group, Spanish Society of Craniomandibular Dysfunction and Orofacial Pain (SEDCYDO), Madrid, Spain
- Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Valencia, Valencia, Spain
- Quality of Life and Health Research Group, Department of Health Sciences, European University of Valencia - Campus Alicante, Alicante, Spain
| | - Pierluigi Sinatti
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, Spain
- IPPOCRATE Centro Medico Specialistico, Ladispoli, Rome, Italy
| | - Eleuterio A Sánchez Romero
- Physiotherapy and Orofacial Pain Working Group, Spanish Society of Craniomandibular Dysfunction and Orofacial Pain (SEDCYDO), Madrid, Spain
- Interdisciplinary Research Group on Musculoskeletal Disorders, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), Majadahonda, Spain
- Quality of Life and Health Research Group, Department of Health Sciences, European University of Valencia - Campus Alicante, Alicante, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, Spain
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Muñoz Montiel A, Ruiz-Esteban P, Doménech Del Río A, Valdivielso P, Sánchez Chaparro MÁ, Olveira C. The effect of pulmonary rehabilitation on cardiovascular risk, oxidative stress and systemic inflammation in patients with COPD. Respir Med 2024; 232:107740. [PMID: 39009098 DOI: 10.1016/j.rmed.2024.107740] [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: 03/22/2024] [Revised: 06/25/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is a leading cause of death, and cardiovascular (CV) comorbidities play a role. Evidence of the pulmonary rehabilitation (PR) effect in reducing the CV risk (CVR) in COPD patients is limited. In this study, we aimed to determine the impact of an 8-week PR program (PRP) on the CVR of the overall population and to compare the impact on the exacerbator versus non-exacerbator patients. PATIENTS AND METHODS This was a prospective study that included adults who had post-bronchodilator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) (FEV1/FVC) ratio <70 % and FEV1 <80 % predicted, had quit smoking for at least 1 year and had a history of tobacco consumption greater than 10 packs/year, and were clinically stable in the last 8 weeks. Pre- and post-PRP assessments included respiratory function evaluation, laboratory tests, and exercise capacity assessment (6-min walking test [6MWT]). CVR was assessed using different risk prediction models. RESULTS A total of 50 patients (28 exacerbators and 22 non-exacerbators) completed the PRP (median age: 64.5 years, men: 72 %; arterial hypertension: 70 %, dyslipidemia: 30 %, diabetes: 20 %; CV disease (CVD): 24 %. After the PRP, exacerbator patients showed a significant decrease in the CVR calculated by the COPDCoRi model (p < 0.001); patients with ≥30-m increase on the 6MWT showed statistically significant lower levels of glucose (p = 0.004), HbA1c (p = 0.004) and BODE index score (p = 0.026) compared to patients with <30-m increase. CONCLUSIONS PR reduced certain modifiable CVR factors and CVD risk, especially in exacerbator patients.
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Affiliation(s)
- Ana Muñoz Montiel
- Pulmonology Service/Unit, Monographic COPD Consultation. Regional University Hospital of Malaga, Malaga, Spain
| | - Pedro Ruiz-Esteban
- Nephrology Department, Regional University Hospital of Malaga, University of Malaga, The Biomedical Research Institute of Malaga (IBIMA), RICORS2040 (RD21/0005/0012), Malaga, Spain.
| | - Adolfo Doménech Del Río
- Pulmonology Service/Unit, Monographic COPD Consultation. Regional University Hospital of Malaga, Malaga, Spain
| | - Pedro Valdivielso
- Laboratory of Lipids and Atherosclerosis, Medico-Sanitarias Research Center (IBIMA), University of Malaga, Malaga, Spain; Internal Medicine, University Hospital Virgen de la Victoria, Department of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), Platform Bionand. University of Malaga, Malaga, Spain
| | - Miguel Ángel Sánchez Chaparro
- Internal Medicine, University Hospital Virgen de la Victoria, Department of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), Platform Bionand. University of Malaga, Malaga, Spain
| | - Casilda Olveira
- Department of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), Platform Bionand. University of Malaga, Malaga, Spain
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Lin MY, Chen SH, Lee JT, Hsu PC. Effectiveness of Respiratory Muscle Training in Pompe Disease: A Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1209. [PMID: 39457174 PMCID: PMC11505692 DOI: 10.3390/children11101209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 09/23/2024] [Accepted: 09/27/2024] [Indexed: 10/28/2024]
Abstract
Background: Pompe disease is a rare metabolic myopathy caused by the lack or deficiency of the lysosomal acid alpha-glucosidase, resulting in skeletal muscle weakness and cardiomyopathy. The disease varies by onset age and genetic mutations and is categorized into infantile-onset and late-onset Pompe disease. Respiratory muscle weakness may persist regardless enzyme replacement therapy. This systemic review and meta-analysis aim to assess the effect of respiratory muscle training (RMT) on respiratory muscle strength, functional endurance, and pulmonary function in patient with Pompe disease. Methods: PubMed, EMBASE, and Cochrane databases were searched up until Aug 2024. Studies examining the therapeutic effects of RMT in patients with Pompe disease were included. Outcome measures included the change in maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), six-minute walking test (6MWT), pulmonary function before after RMT, quality of life and adverse events. Results: The meta-analysis consisted of 5 single-arm studies, including 31 patients in total. Regarding inspiratory muscle strength, RMT has significantly improving MIP (8.71 cmH2O; 95% CI, 6.23-11.19, p < 0.001) and MEP (12.15 cmH2O; 95% CI, 10.55-13.74, p < 0.001) in both types of Pompe disease. However, no significant change regarding 6MWT. No serious adverse events were reported. Conclusions: Our meta-analysis revealed that RMT may increase inspiratory muscle and expiratory muscle strength, but may not have an effect on 6MWT in patients with Pompe disease. RMT has potential to be integrated into the cardioplulmonary rehabilitation for patients with Pompe disease. Further large randomized controlled trials are needed to verify the efficacy and safety of RMT in patients with Pompe disease.
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Affiliation(s)
- Mu-Yun Lin
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei City 112201, Taiwan; (M.-Y.L.); (J.-T.L.)
| | - Szu-Han Chen
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei City 11221, Taiwan
| | - Jen-Ting Lee
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei City 112201, Taiwan; (M.-Y.L.); (J.-T.L.)
| | - Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, West Garden Hospital, Taipei City 108035, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei City 10845, Taiwan
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Vidoni ED, Grove G, Szabo-Reed AN, Key MN, Huang H, Burns JM, Hillman CH, Jakicic JM, Kang C, Kramer AF, McAuley E, Wan L, Hawes T, White SS, Erickson KI. Adverse Events During a 12-month Multi-Site and Dose-Response Aerobic Exercise Intervention. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.10.24313352. [PMID: 39314981 PMCID: PMC11419234 DOI: 10.1101/2024.09.10.24313352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Purpose This study aimed to assess the incidence of adverse events (AE) in older adults participating in a year-long exercise intervention, investigating potential dose-response relationships between exercise intensity and AE frequency, and identifying demographic factors associated with AE risk. Methods A total of 648 older adults were randomized into one of three exercise groups: low-intensity stretching and toning (S&T), 150 minutes of aerobic exercise per week (150Ex), or 225 minutes of aerobic exercise per week (225Ex). Adverse events were tracked during the intervention, with event rates calculated based on participant adherence and time in the study. Generalized linear models were employed to compare AE incidence across groups. Post hoc comparisons were used to calculate incidence rate ratios (IRRs) for AE between groups, adjusting for multiple comparisons. Results Overall, 306 AE were reported, with 44% related to the intervention. No significant dose-response relationship was observed for all-cause AE between groups. However, intervention-related AE were more frequent in the aerobic exercise groups. Participants in the 150Ex group had a 77% higher rate of intervention-related AE compared to the S&T group, and the 225Ex group had an 88% higher rate. Higher adherence was associated with fewer all-cause AE, and greater comorbid burden was associated with more AE. Conclusions While aerobic exercise increased the risk of intervention-related AE, the overall risk remained low. Higher adherence to the exercise regimen was associated with fewer AE. These findings suggest aerobic exercise is generally safe in older adults, with the benefits outweighing the risks.
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Affiliation(s)
- Eric D Vidoni
- University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - George Grove
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | | | - Mickeal N Key
- University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Haiqing Huang
- AdventHealth Research Institute, Neuroscience, Orlando, FL, 32804, USA
| | - Jeffrey M Burns
- University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
- Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, MA, 02115, USA
| | - John M Jakicic
- University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Chaeryon Kang
- Department of Psychiatry, University of Pittsburgh, PA, 15213, USA
- Department of Biostatistics, University of Pittsburgh, PA, 15213, USA
| | - Arthur F Kramer
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, IL, 61801, USA
- Center for Cognitive & Brain Health, Northeastern University, Boston, MA. 02115, USA
| | - Edward McAuley
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, IL, 61801, USA
- Department of Health and Kinesiology, University of Illinois at Urbana Champaign, IL, 61801, USA
| | - Lu Wan
- AdventHealth Research Institute, Neuroscience, Orlando, FL, 32804, USA
| | - Tera Hawes
- University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Sydney S White
- University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Kirk I Erickson
- AdventHealth Research Institute, Neuroscience, Orlando, FL, 32804, USA
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21
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Drwal KR, Hurst D, Wakefield BJ. Effectiveness of a Home-Based Pulmonary Rehabilitation Program in Veterans. Telemed J E Health 2024; 30:2456-2465. [PMID: 35584256 DOI: 10.1089/tmj.2022.0050] [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] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study examined the effectiveness and safety of a home-based pulmonary rehabilitation (HBPR) program in Veterans. Methods: Patients were evaluated from five Veteran Affairs facilities that enrolled in the 12-week program. Pre- to postchanges were completed on clinical outcomes using paired t-tests and the Wilcoxon signed rank sum test. Descriptive statistics were used for patient demographics, emergency room visits, and hospitalizations. Results: Two hundred eighty-five patients with a mean age of 69.6 ± 8.3 years enrolled in the HBPR program from October 2018 to March 2020. There was a 62% (n = 176) completion rate of both pre- and post assessments. Significant improvements were detected after completion of the HBPR program in dyspnea (modified Medical Research Council: 3.1 ± 1.1 vs. 1.9 ± 1.1; p < 0.0001); exercise capacity (six-minute walk distance: 263.1 m ± 96.6 m vs. 311.0 m ± 103.6 m; p < 0.0001; Duke Activity Status Index: 13.8 ± 9.6 vs. 20.0 ± 12.7; p < 0.0001; self-reported steps per day: 1514.5 ± 1360.4 vs. 3033.8 ± 2716.2; p < 0.0001); depression (patient health questionnaire-9: 8.3 ± 5.7 vs. 6.4 ± 5.1); nutrition habits (rate your plate, heart: 45.3 ± 9.0 vs. 48.9 ± 9.2; p < 0.0001); multicomponent assessment tools (BODE Index: 5.1 ± 2.5 vs. 3.4 ± 2.4; p < 0.0001), GOLD ABCD Assessment: p < 0.0009); and quality of life (chronic obstructive pulmonary disease assessment test: 25.4 ± 7.7 vs. 18.7 ± 8.5; p < 0.0001). No adverse events were reported due to participation in HBPR. Conclusions: The HBPR program is a safe and effective model and provides an additional option to address the gap in pulmonary rehabilitation access and utilization in the Veterans Affairs.
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Affiliation(s)
- Kariann R Drwal
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- The Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Delanie Hurst
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- The Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Bonnie J Wakefield
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- The Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
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22
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Zhu Y, Zhang Z, Du Z, Zhai F. Mind-body exercise for patients with stable COPD on lung function and exercise capacity: a systematic review and meta-analysis of RCTs. Sci Rep 2024; 14:18300. [PMID: 39112599 PMCID: PMC11306772 DOI: 10.1038/s41598-024-69394-4] [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: 06/05/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a global health concern. Mind-body exercises like Tai Chi and Yoga are suggested as non-pharmacological interventions for COPD management. This meta-analysis evaluates mind-body exercises' impact on lung function and exercise capacity in stable COPD patients, aiming to assess their effectiveness in rehabilitation. A systematic search across various databases identified relevant randomized controlled trials until April 2024. Primary outcomes included lung function tests (FEV1, FVC, FEV1/FVC, FEV1%) and Six-Minute Walk Test (6MWT) results. The Standardized Mean Difference (SMD) measured intervention effects. Fifteen studies with 1047 participants were analyzed. Mind-body exercises significantly improved FEV1 (SMD = 0.87), FEV1/FVC (SMD = 0.19), FEV1% (SMD = 0.43), and 6MWT (SMD = 1.21) compared to standard care. Sensitivity and subgroup analyses confirmed result stability despite some heterogeneity.In conclusion, Mind-body exercises enhance lung function and exercise capacity in stable COPD patients. Integrating them into comprehensive rehabilitation programs is advisable. Further research should explore the specific impacts of different exercise types and intensities.
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Affiliation(s)
- Yutong Zhu
- College of Physical Education, China University of Mining and Technology, Xuzhou, Jiangsu, China
| | - Zhihao Zhang
- Collge of Education, National University of Malaysia, Bangi, Selangor, Malaysia
| | - Zhihao Du
- College of Physical Education, China University of Mining and Technology, Xuzhou, Jiangsu, China.
| | - Feng Zhai
- College of Physical Education, China University of Mining and Technology, Xuzhou, Jiangsu, China.
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23
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Oliveira MR, Hoffman M, Jones AW, Holland AE, Borghi-Silva A. Effect of Pulmonary Rehabilitation on Exercise Capacity, Dyspnea, Fatigue, and Peripheral Muscle Strength in Patients With Post-COVID-19 Syndrome: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:1559-1570. [PMID: 38311096 DOI: 10.1016/j.apmr.2024.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE To establish the effects of pulmonary rehabilitation (PR) in patients with persistent symptoms after COVID-19 infection. In addition, to compare the modalities of PR services (face-to-face and telerehabilitation) and the duration of PR in weeks (4-8 weeks and >8 weeks). DATA SOURCES PubMed/MEDLINE, Embase (Elsevier), Central/Cochrane Library, SciELO Citation Index (Web of Science), and CINAHL. STUDY SELECTION Studies determining the effects of PR in patients with post-COVID-19 syndrome were included and grouped according to PR delivery modality. DATA EXTRACTION Data extraction and quality assessment were independently performed by 2 reviewers. The methodological quality was assessed using the Cochrane Risk of Bias Tool 1 (RoB-1). DATA SYNTHESIS The literature search retrieved 1406 articles, of which 7 studies explored the effects of PR on patients with post-COVID-19 syndrome, with 188 patients randomized to PR. The mean age of participants was 50 years and 49% were women. Meta-analysis showed an increase in exercise capacity with PR compared with control (6-minute walking test: mean difference: 60.56 m, 95% confidence interval: 40.75-80.36), a reduction in fatigue (Fatigue Severity Scale: -0.90, -1.49 to -0.31) but no change in dyspnea (-0.57, -1.32 to 0.17) and muscle strength (3.03, -1.89 to 7.96). There were no differences between telerehabilitation and face-to-face PR regarding effects on peripheral muscle strength (P=.42), dyspnea (P=.83), and fatigue (P=.34). There were no differences between programs 4-8 weeks and >8 weeks regarding exercise capacity (P=.83), peripheral muscle strength (P=.42), and dyspnea (P=.76). CONCLUSIONS PR improves exercise capacity and reduces fatigue in patients with post-COVID-19 syndrome. Duration of PR (4-8 weeks vs > 8 weeks) or PR modality (telerehabilitation vs face-to-face) did not affect outcomes but data were limited and based on subgroup analysis. Further evidence is required to determine the optimal delivery mode and duration of PR for post-COVID-19 syndrome.
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Affiliation(s)
- Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, Brazil; Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil.
| | - Mariana Hoffman
- Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil
| | - Arwel W Jones
- Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil
| | - Anne E Holland
- Respiratory Research@Alfred, Monash University, São Carlos (SP), Brazil; Physiotherapy Department, Alfred Health, Melbourne, Australia
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, Brazil; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL
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Akinci B, Emirza Cilbir C, Kocyigit A, Kuran Aslan G. Respiratory Muscle Training in Para-Athletes: A Systematic Review on the Training Protocols and Effects on Reported Outcomes. J Sport Rehabil 2024:1-9. [PMID: 38996453 DOI: 10.1123/jsr.2023-0301] [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: 09/12/2023] [Revised: 02/20/2024] [Accepted: 04/16/2024] [Indexed: 07/14/2024]
Abstract
CONTEXT AND OBJECTIVES Respiratory muscle training (RMT) is considered an effective tool to improve cardiorespiratory limitations in athletes. The goals of this systematic review were to explore the role of RMT and its implementation within sport rehabilitation programs in para-athletes. EVIDENCE ACQUISITION Several databases were searched until January 2024. Eligible studies were independently reviewed by 2 reviewers. Quality assessment was made using the PEDro scale and version 2 of the Cochrane Risk-of-Bias Tool for Randomized Trials. Eight studies (a total of 108 participants) were selected for the analysis. EVIDENCE SYNTHESIS Five studies preferred using resistive loading, while 2 studies used normocapnic hyperpnea, and 1 study used threshold inspiratory muscle training. Respiratory functions (respiratory muscle strength and endurance, spirometry measures) and exercise performance were assessed as the main outcomes. Significant increases in respiratory muscle strength were reported in 5 studies. Two studies observed improvement in respiratory muscle endurance and 3 studies reported increased exercise capacity. CONCLUSIONS This review suggests that although RMT can enhance respiratory muscle strength and endurance, it should not be considered the primary method for boosting the exercise performance of para-athletes. Additional research is necessary to explore the impact of various RMT techniques on different outcomes from the perspective of sport rehabilitation in para-athletes.
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Affiliation(s)
- Buket Akinci
- Department of Physiotherapy and Rehabilitation (English), Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Cigdem Emirza Cilbir
- Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Kocyigit
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Goksen Kuran Aslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Koopman M, Posthuma R, Vanfleteren LEGW, Simons SO, Franssen FME. Lung Hyperinflation as Treatable Trait in Chronic Obstructive Pulmonary Disease: A Narrative Review. Int J Chron Obstruct Pulmon Dis 2024; 19:1561-1578. [PMID: 38974815 PMCID: PMC11227310 DOI: 10.2147/copd.s458324] [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: 02/06/2024] [Accepted: 06/12/2024] [Indexed: 07/09/2024] Open
Abstract
Lung hyperinflation (LH) is a common clinical feature in patients with chronic obstructive pulmonary disease (COPD). It results from a combination of reduced elastic lung recoil as a consequence of irreversible destruction of lung parenchyma and expiratory airflow limitation. LH is an important determinant of morbidity and mortality in COPD, partially independent of the degree of airflow limitation. Therefore, reducing LH has become a major target in the treatment of COPD over the last decades. Advances were made in the diagnostics of LH and several effective interventions became available. Moreover, there is increasing evidence suggesting that LH is not only an isolated feature in COPD but rather part of a distinct clinical phenotype that may require a more integrated management. This narrative review focuses on the pathophysiology and adverse consequences of LH, the assessment of LH with lung function measurements and imaging techniques and highlights LH as a treatable trait in COPD. Finally, several suggestions regarding future studies in this field are made.
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Affiliation(s)
- Maud Koopman
- Research and Development, Ciro+, Horn, the Netherlands
- NUTRIM, Institute of Nutrition and Translational Research in Metabolism, University Maastricht, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Rein Posthuma
- Research and Development, Ciro+, Horn, the Netherlands
- NUTRIM, Institute of Nutrition and Translational Research in Metabolism, University Maastricht, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Lowie E G W Vanfleteren
- COPD Center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Sami O Simons
- NUTRIM, Institute of Nutrition and Translational Research in Metabolism, University Maastricht, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Frits M E Franssen
- Research and Development, Ciro+, Horn, the Netherlands
- NUTRIM, Institute of Nutrition and Translational Research in Metabolism, University Maastricht, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
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26
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Thakkar D, Singh S, Wairkar S. Advanced Delivery Strategies of Nintedanib for Lung Disorders and Beyond: A Comprehensive Review. AAPS PharmSciTech 2024; 25:150. [PMID: 38954161 DOI: 10.1208/s12249-024-02869-9] [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: 02/29/2024] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
Nintedanib, a primary treatment for lung fibrosis, has gathered substantial attention due to its multifaceted potential. A tyrosine kinase inhibitor, nintedanib, inhibits multiple signalling receptors, including endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor (PDGFR), and fibroblast growth factor receptor (FGFR) and ultimately inhibits fibroblast proliferation and differentiation. Therefore, nintedanib has been studied widely for other ailments like cancers and hepatic fibrosis, apart from lung disorders. Commercially, nintedanib is available as soft gelatin capsules for treatment against idiopathic pulmonary fibrosis. Since it has very low oral bioavailability (4.7%), high doses of a drug, such as 100-150 mg, are administered, which can cause problems of gastrointestinal irritation and hepatotoxicity. The article begins with exploring the mechanism of action of nintedanib, elucidating its complex interactions within cellular pathways that govern fibrotic processes. It also emphasizes the pharmacokinetics of nintedanib, clinical trial insights, and the limitations of conventional formulations. The article mainly focuses on the emerging landscape of nanoparticle-based carriers such as hybrid liposome-exosome, nano liquid crystals, discoidal polymeric, and magnetic systems, offering promising avenues to optimize drug targeting, address its efficacy issues and minimise adverse effects. However, none of these delivery systems are commercialised, and further research is required to ensure safety and effectiveness in clinical settings. Yet, as research progresses, these advanced delivery systems promise to revolutionise the treatment landscape for various fibrotic disorders and cancers, potentially improving patient outcomes and quality of life.
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Affiliation(s)
- Dhruti Thakkar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKMs NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, Maharashtra, 400056, India
| | - Sanskriti Singh
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKMs NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, Maharashtra, 400056, India
| | - Sarika Wairkar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKMs NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, Maharashtra, 400056, India.
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27
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Polastri M, Pehlivan E, Reed RM. Inspiratory Muscle Training for Lung Transplant Candidates and Recipients. EXP CLIN TRANSPLANT 2024; 22:479-486. [PMID: 39223806 DOI: 10.6002/ect.2024.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVES Inspiratory muscle training is used in rehabilitation to exercise respiratory muscles in various conditions associated with limited ventilatory reserve. In this review, we investigated inspiratory muscle training in lung transplant candidates and recipients. MATERIALS AND METHODS We searched 5 primary databases from inception through April 2024. Two key word entries, "lung transplantation" and "inspiratory muscle training," were matched using the Boolean operator AND. No filters were applied for document type, age, sex, publication date, language, and subject. RESULTS AND CONCLUSIONS The searched databases returned 119 citations. Seven articles that considered 64 patients (47% female) were included in the final analysis, with 1 study involving a pediatric patient. Lung transplant recipients used a threshold trainer at 15% to 60% of maximal inspiratory pressure and mostly exercised twice daily for 10 to 15 minutes per session. Lung transplant candidates exercised at 30% to >50% of maximal inspiratory pressure twice daily, performing 30 to 60 inspirations or for 15 minutes. The highest inspiratory muscle strength was observed in a series of adult lung transplant recipients whose mean value improved by 31.8 ± 14.6 cmH2O versus baseline after treatment. To the same extent, the highest value of maximal inspiratory pressure was detected in a pediatric patient who scored 180 cmH2O after training. Overall, participants obtained improvements in lung function (forced expiratory volume in 1 second, forced vital capacity), functional performance, dyspnea intensity, and exercise tolerance. Inspiratory muscle training is easy to perform and can be done at home without specific supervision (in adults) before or after a lung transplant. Nevertheless, additional rigorous investigations should aim to replicate the positive effects reported in the present review.
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Affiliation(s)
- Massimiliano Polastri
- >From the Department of Continuity of Care and Integration, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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28
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Wang Z, Zhu Z, Sun Y, Wang T, Lu Y, Che W, Liu W, Xu Y. The Rehabilitation Efficacy of the Novel Metronomic Breathing Technique for Gerontic Patients After Percutaneous Coronary Intervention for Acute Myocardial Infarction-A Pilot Study. Clin Interv Aging 2024; 19:1029-1039. [PMID: 38863479 PMCID: PMC11166167 DOI: 10.2147/cia.s458675] [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] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/21/2024] [Indexed: 06/13/2024] Open
Abstract
Background The respiratory rehabilitation technique is a crucial component of early cardiac recovery in geriatric patients with acute myocardial infarction (AMI). This study primarily investigated the effectiveness of a novel respiratory rehabilitation technique, metronomic breathing (MB), on geriatric patients after percutaneous coronary intervention for AMI and compliance with home-based rehabilitation compared to traditional respiratory rehabilitation. Methods From June 2022 to March 2023, 75 acute myocardial infarction (AMI) patients admitted to the Shanghai Tenth People's Hospital Cardiovascular Department were consecutively enrolled. Ultimately, 46 patients completed the follow-up in this study-26 in the MB group and 20 in the control group-who underwent the novel MB technique and conventional abdominal breathing training. The primary endpoint of the study was left ventricular function measured by noninvasive hemodynamics three months after discharge. The secondary endpoints were compliance and quality of life after three months of home rehabilitation. Results After the intervention, several cardiac functional parameters (SV, SVI, CO, CI, LCW, and LCWI), myocardial contractility parameters (VI), and systemic vascular resistance parameters (SVR and SVRI) were significantly greater in the MB group than in the preintervention group (P < 0.05). Furthermore, post-treatment, the MB group exhibited greater SV, SVI, CO, CI, and VI; lower SVR, SVRI, and SBP; and a lower readmission rate three months later than did the control group. The SF-36 scores after three months of MB intervention, PE, BP, GH, VT, SF, RE, and MH, were all significantly greater than those before treatment (P < 0.05). Moreover, the MB group displayed greater compliance with home-based cardiac rehabilitation (P < 0.05). Conclusion Compared to conventional respiratory rehabilitation training methods, short-term metronomic respiratory therapy is more effective for reducing systemic vascular resistance, enhancing left ventricular ejection function, enhancing quality of life, and increasing home-based rehabilitation compliance in geriatric patients following AMI with PCI.
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Affiliation(s)
- Zeyu Wang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Zhaoxin Zhu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Yifan Sun
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Ting Wang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Yunlan Lu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Weijing Liu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
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29
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Saha R, Singh VP, Samuel SR, Vishak Acharya K, Acharya PR, Vijaya Kumar K. Effect of Home-Based Pulmonary Rehabilitation on Pulmonary Fibrosis. Multidiscip Respir Med 2024; 19:950. [PMID: 38836339 PMCID: PMC11186438 DOI: 10.5826/mrm.2024.950] [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: 12/14/2023] [Accepted: 04/08/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Pulmonary fibrosis is a chronic, progressive lung condition that involves lung tissue scarring and thickening. The effects of home-based pulmonary rehabilitation (PR) in post-covid pulmonary fibrosis (PCPF) and other forms of fibrosis together have not been evaluated. This study aims to evaluate the effectiveness of home-based pulmonary rehabilitation on pulmonary function, functional capacity, and health-related quality of life in people with pulmonary fibrosis (post-COVID pulmonary fibrosis, pulmonary fibrosis secondary to pulmonary tuberculosis (TB), pulmonary fibrosis secondary to interstitial lung disease (ILD), pulmonary fibrosis secondary to bronchiectasis). METHODS A single-group pretest-posttest experimental study was performed after recruiting 98 pulmonary fibrosis subjects from K.M.C hospitals. After being screened for the inclusion and exclusion criteria, 45 subjects were analyzed, and 6 subjects were lost to follow-up. A home-based pulmonary rehabilitation program was carried out for 8 weeks (warm-up, stretching exercises, aerobic exercise, strength training for upper limb and lower limb, breathing exercises mainly involved; others: energy saving techniques, controlled coughing techniques, dyspnea relieving positions). The program was supervised via weekly phone calls. Pulmonary function (Pulmonary function test), exercise capacity (6-minute walk test), dyspnea (modified Borg scale), and health-related quality of life (SF-36) were evaluated before and after the intervention. During the enrollment and after the 6-minute walk test, saturation of peripheral oxygen (SPO2) level was also evaluated pre-intervention and after the 8-weeks program. RESULTS Pulmonary function [FVC(L) t = -12.52, p<0.05; FEV1(L) t = -2.56, p<0.05; FEV1/FVC t = 7.98, p<0.05 and DLCO (ml/min/mmHg) t = -5.13, p<0.05], 6MWD [MD 88.66; p<0.05] and HRQOL measured by SF-36 scores (p<0.05) were improved significantly. Both the baseline SPO2 level before the 6MWT [MD 1.07, p<0.05] and the SPO2 level after the 6MWT [MD 1.16, p<0.05] showed a significant improvement. The rating of perceived exertion(dyspnea) [MD 1.30, p<0.05] was reduced significantly after the 8-week program. CONCLUSION Our study shows that home-based pulmonary rehabilitation is an effective option for improving lung function and physical functional capacity by reducing dyspnea perception and improving the saturation of peripheral oxygen (SPO2) level, and enhancing the quality of life in people with pulmonary fibrosis.
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Affiliation(s)
- Rashmita Saha
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
| | - Vijay Pratap Singh
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
| | - Stephen Rajan Samuel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
| | - K Vishak Acharya
- Department of Pulmonary Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India
| | - Preetam Rajgopal Acharya
- Department of Pulmonary Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India
| | - K. Vijaya Kumar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
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Blanco Loures J, Guimarães Assis M, Pereira HLA, Mancuzo EV, Parreira VF. Perception of patients with interstitial lung diseases submitted to inspiratory muscle training. Physiother Theory Pract 2024; 40:1317-1325. [PMID: 36326066 DOI: 10.1080/09593985.2022.2141598] [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: 03/16/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although inspiratory muscle training reduces dyspnea in patients with chronic respiratory diseases, it was not yet evaluated in a sample composed exclusively of patients with interstitial lung diseases. OBJECTIVE To discuss the perception of patients with interstitial lung diseases about inspiratory muscle training intervention. METHODS This is a qualitative study. Data were collected using semi-structured interviews, transcribed, and analyzed by thematic analysis. RESULTS Fourteen patients (64 ± 7 years) with interstitial lung disease were interviewed. Average participation in the inspiratory muscle training program was 90% (range, 66-100%). Three themes were elaborated: 1) dyspnea and other symptoms in daily life (e.g. "I could not carry out a bag; I was very uncomfortable"); 2) less symptom and greater performance (e.g. "I wash and change my clothes, house cleaning, do everything without feeling anything"); and 3) IMT: a time dedicated to my health (e.g. "For me it was great because I saw my evolution every day"). CONCLUSION Patients noticed improvements in symptoms and performance related to daily activities. Despite initial difficulties, patients continued training as planned.
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Affiliation(s)
- Jéssica Blanco Loures
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcella Guimarães Assis
- Department of Occupacional Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Eliane Viana Mancuzo
- Department of Medical Clinic, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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31
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Naqvi M, Hannah J, Lawrence A, Myall K, West A, Chaudhuri N. Antifibrotic therapy in progressive pulmonary fibrosis: a review of recent advances. Expert Rev Respir Med 2024; 18:397-407. [PMID: 39039699 DOI: 10.1080/17476348.2024.2375420] [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: 03/27/2024] [Accepted: 06/28/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Progressive pulmonary fibrosis (PPF) is a manifestation of a heterogenous group of underlying interstitial lung disease (ILD) diagnoses, defined as non-idiopathic pulmonary fibrosis (IPF) progressive fibrotic ILD meeting at least two of the following criteria in the previous 12 months: worsening respiratory symptoms, absolute decline in forced vital capacity (FVC) more than or equal to 5% and/or absolute decline in diffusing capacity for carbon monoxide (DLCO) more than or equal to 10% and/or radiological progression. AREAS COVERED The authors subjectively reviewed a synthesis of literature from PubMed to identify recent advances in the diagnosis and characterisation of PPF, treatment recommendations, and management challenges. This review provides a comprehensive summary of recent advances and highlights future directions for the diagnosis, management, and treatment of PPF. EXPERT OPINION Recent advances in defining the criteria for PPF diagnosis and licensing of treatment are likely to support further characterisation of the PPF patient population and improve our understanding of prevalence. The diagnosis of PPF remains challenging with the need for a specialised ILD multidisciplinary team (MDT) approach. The evidence base supports the use of immunomodulatory therapy to treat inflammatory ILDs and antifibrotic therapy where PPF develops. Treatment needs to be tailored to the specific underlying disease and determined on a case-by-case basis.
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Affiliation(s)
- Marium Naqvi
- Guy's and St Thomas' NHS Trust, Guy's Hospital, London, UK
| | - Jennifer Hannah
- Department of Rheumatology, Kings' College Hospitals NHS Trust, Orpington Hospital, Orpington, UK
| | | | - Katherine Myall
- Department of Respiratory Medicine, King's College London, London, UK
| | - Alex West
- Guy's and St Thomas' NHS Trust, Guy's Hospital, London, UK
| | - Nazia Chaudhuri
- Department of Health and Life Sciences, School of Medicine, Ulster University, Derry-Londonderry, UK
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32
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Toprak Celenay S, Secer E, Ozer Kaya D. Effects of 16-week circuit training on physical fitness parameters, pulmonary function, and quality of life in healthy women. J Sports Med Phys Fitness 2024; 64:516-525. [PMID: 38358367 DOI: 10.23736/s0022-4707.24.15707-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Circuit training (CT) is an important type of training that can combine different types of exercises in a single form of training. This study aimed to investigate the effects of 16-week CT on physical fitness parameters, pulmonary function, and quality of life in healthy women. METHODS Twenty-nine healthy women (median age: 37.00 [31.50/39.50] years) were included in the study. CT was applied to the participants for a total of 16 weeks. Participants' body composition with the Bioelectrical Impedance Analysis System, knee flexor and extensor muscle strength with the Biodex System-4 Pro, flexibility with the sit-and-reach test, pulmonary function with a spirometer device, and quality of life with Short Form-36 were assessed. RESULTS A significant difference was found between the participants' pretest and posttest median and interquartile range values of waist-hip ratio, body mass index, right/left knee flexor/extensor mean peak torque (60°/s,180°/s), right hamstring/quadriceps (H/Q) ratio (60°/s), flexibility, and SF-36 Mental Health Score (P˂0.050). There was no significant difference between the participants' pretest and posttest median and interquartile range values of total body fat, fat percentage, right H/Q ratio (180°/s), left H/Q ratio (60°/s,180°/s), pulmonary function, and Short Form-36 Physical Function Score (P˃0.050). CONCLUSIONS CT decreased waist-hip ratio and body mass index, increased knee flexor/extensor strength and flexibility, and improved mental health. The 16-week CT may be an alternative approach to improve physical fitness parameters and mental health without any positive effects on body fat and pulmonary functions in healthy women.
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Affiliation(s)
- Seyda Toprak Celenay
- Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Erhan Secer
- Department of Physiotherapy and Rehabilitation, Manisa Celal Bayar University, Manisa, Türkiye -
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Türkiye
- Physiotherapy and Rehabilitation Research and Application Center, Izmir Katip Celebi University, Izmir, Türkiye
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Jakobsson J, Stoffels AAF, van Hees HWH, De Brandt J, Nyberg A, Klijn P. Quality of aerobic training description and its relation to intervention efficacy in chronic obstructive pulmonary disease trials: study protocol for a systematic review, meta-analysis and meta-regression. BMJ Open 2024; 14:e084296. [PMID: 38803267 PMCID: PMC11129019 DOI: 10.1136/bmjopen-2024-084296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a major global health concern, characterised by ventilatory constraints, decreased cardiovascular fitness and reduced limb muscle function, profoundly affecting patients' quality of life. Aerobic training plays a crucial role in the treatment of COPD, but the variability in methodologies and incomplete reporting of key components in aerobic training trials limits the assessment of their effectiveness. This systematic review aims to critically evaluate the application of training principles and reporting of key components in aerobic training trials in randomised controlled trials (RCTs) in the COPD literature. METHODS AND ANALYSIS The protocol adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocol guidelines. The review will include RCTs utilising aerobic training in individuals with COPD. A comprehensive search, following a predefined search strategy will identify studies published from 2007 to 2024 in English from MEDLINE, Embase, CINAHL, CENTRAL and PEDro. Studies including people with COPD and any aerobic training intervention will be included. Two reviewers will independently screen abstracts and titles for inclusion. Two reviewers will independently conduct the screening of full-text documents and data extraction. Study quality will be assessed using the Tool for the assESsment of sTudy quality and bias in Exercise, specifically developed for exercise training studies. The certainty of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. A systematic synthesis will be provided, with meta-analyses and meta-regression when appropriate. ETHICS AND DISSEMINATION As this review will involve the analysis of published data, ethical approval is not required. The findings of this review will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42021247343.
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Affiliation(s)
- Johan Jakobsson
- Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden
| | - Anouk A F Stoffels
- Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, Gelderland, Netherlands
| | - Hieronymus W H van Hees
- Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, Gelderland, Netherlands
| | - Jana De Brandt
- Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden
| | - André Nyberg
- Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden
| | - Peter Klijn
- Merem Pulmonary Rehabilitation Center, Hilversum, Netherlands
- Department of Pulmonary Medicine, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, Netherlands
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Singh P. Commentary on Schertzer et al. 1. Physiother Can 2024; 76:218-219. [PMID: 38725593 PMCID: PMC11078253 DOI: 10.3138/ptc-2021-0135-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Prashna Singh
- Certified Respiratory Educator Pulmonary Rehabilitation Coordinator, Trillium Health Partners, Mississauga, Ontario, Canada;
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35
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Colombo V, Mondellini M, Fumagalli A, Aliverti A, Sacco M. A virtual reality-based endurance training program for COPD patients: acceptability and user experience. Disabil Rehabil Assist Technol 2024; 19:1590-1599. [PMID: 37272556 DOI: 10.1080/17483107.2023.2219699] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To investigate the acceptability and user experience of an in-hospital endurance training program based on the Virtual Park, a semi-immersive Virtual Reality (VR) system for patients with Chronic Obstructive Pulmonary Disease (COPD).Materials and methodsPatients performed 20 min of cycling two times/day for around ten days. The evaluation included adherence, exercise capacity, physical performance, and user experience. RESULTS Fourteen patients (6 F/8 M; age = 71.29 ± 6.93 years) with mild/moderate COPD participated. The adherence rate was satisfying: 85.71% of patients attended the program without adverse events; the individual attendance rate (86.85% ± 27.43) was also high. The exercise capacity assessed before and after the training significantly improved in our group (6MWT pre-post: t(11)= -5.040, p < 0.05), as happens in standard PR programs. The physical performance metrics of each session indicate that all participants could sustain the proposed training protocol over the whole period. Patients judged the VR experience positively (User Experience Questionnaire = 1.84 ± 0.22) and were highly engaged in the activity for the whole period (Short Flow State Scale pre-post: 4.61 ± 0.27/4.40 ± 0.36). CONCLUSIONS Our preliminary results open the possibility for further investigations on long-term motivation and clinical effectiveness of more immersive VR interventions for COPD.
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Affiliation(s)
- Vera Colombo
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council (CNR), Lecco, Italy
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milano, Italy
| | - Marta Mondellini
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council (CNR), Lecco, Italy
| | | | - Andrea Aliverti
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milano, Italy
| | - Marco Sacco
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council (CNR), Lecco, Italy
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36
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Singh S, Wairkar S. Revolutionizing the Treatment of Idiopathic Pulmonary Fibrosis: From Conventional Therapies to Advanced Drug Delivery Systems. AAPS PharmSciTech 2024; 25:78. [PMID: 38589751 DOI: 10.1208/s12249-024-02793-y] [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: 12/14/2023] [Accepted: 03/16/2024] [Indexed: 04/10/2024] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive interstitial lung disease that has been well-reported in the medical literature. Its incidence has risen, particularly in light of the recent COVID-19 pandemic. Conventionally, IPF is treated with antifibrotic drugs-pirfenidone and nintedanib-along with other drugs for symptomatic treatments, including corticosteroids, immunosuppressants, and bronchodilators based on individual requirements. Several drugs and biologicals such as fluorofenidone, thymoquinone, amikacin, paclitaxel nifuroxazide, STAT3, and siRNA have recently been evaluated for IPF treatment that reduces collagen formation and cell proliferation in the lung. There has been a great deal of research into various treatment options for pulmonary fibrosis using advanced delivery systems such as liposomal-based nanocarriers, chitosan nanoparticles, PLGA nanoparticles, solid lipid nanocarriers, and other nanoformulations such as metal nanoparticles, nanocrystals, cubosomes, magnetic nanospheres, and polymeric micelles. Several clinical trials are also ongoing for advanced IPF treatments. This article elaborates on the pathophysiology of IPF, its risk factors, and different advanced drug delivery systems for treating IPF. Although extensive preclinical data is available for these delivery systems, the clinical performance and scale-up studies would decide their commercial translation.
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Affiliation(s)
- Sanskriti Singh
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, 400056, Maharashtra, India
| | - Sarika Wairkar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, 400056, Maharashtra, India.
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37
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Hussain A, Khurana AK, Goyal A, Kothari SY, Soman RK, Tej S, Pakhare A. Effect of pulmonary rehabilitation in patients with post-tuberculosis sequelae with functional limitation. Indian J Tuberc 2024; 71:123-129. [PMID: 38589115 DOI: 10.1016/j.ijtb.2023.04.012] [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: 10/30/2022] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Pulmonary rehabilitation improves dyspnea, functional limitation and quality of life in patients with chronic respiratory disease especially Chronic obstructive pulmonary disease (COPD). Whether Pulmonary rehabilitation (PR) will have similar effect in patients with post-tuberculosis sequelae or not and whether the two morphological variants will respond similarly or not was the purpose of our study. METHODS Adult patients fulfilling the inclusion criteria of a diagnosis of post-tuberculosis sequelae with functional limitation (modified medical research council [mMRC] grade 1 or more) were recruited over a period of two years. A baseline health assessment in the different domains of health was done at the beginning and repeated just after the completion of the rehabilitation program at 6 weeks. RESULTS 26 patients completed the PR protocol of our study. Dyspnea improved from an mMRC grade of 1.5 to 0.7 post-PR (p < 0.001). 6MWD increased by 34 meters from a baseline value of 408.6 meters to 442.7 meters post-PR. (p-value 0.3) St. George's Respiratory Questionnaire (SGRQ) symptom score decreased by 13 points, SGRQ activity score decreased by 18 points, SGRQ impact score decreased by 18 and SGRQ total score decreased by 17 points with p-values of 0.037, 0.002, 0.004 and 0.002 for SGRQ symptom score, SGRQ activity score, SGRQ impact score, SGRQ total score respectively. Depression Anxiety Stress Scale (DASS) Stress score decreased by 6.7, DASS Anxiety score decreased by 6.6, and DASS Depression score decreased by 5.5 points. Intergroup comparison revealed both bronchiectasis predominant group and fibrosis predominant group responded similarly to PR. CONCLUSION PR improved parameters assessing dyspnea, quality of life and mental health indices significantly. Improvement in functional capacity was not statically significant. Both the morphological variants responded similarly to the PR.
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Affiliation(s)
- Aqeel Hussain
- Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India.
| | | | - Abhishek Goyal
- Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India.
| | - S Y Kothari
- Physical Medicine & Rehabilitation, AIIMS Bhopal, India.
| | | | - Sai Tej
- Pulmonary, Critical Care & Sleep Medicine, AIIMS Bhopal, India.
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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SN, Agaltsov MV, Alekseeva LI, Almazova II, Andreenko EY, Antipushina DN, Balanova YA, Berns SA, Budnevsky AV, Gainitdinova VV, Garanin AA, Gorbunov VM, Gorshkov AY, Grigorenko EA, Jonova BY, Drozdova LY, Druk IV, Eliashevich SO, Eliseev MS, Zharylkasynova GZ, Zabrovskaya SA, Imaeva AE, Kamilova UK, Kaprin AD, Kobalava ZD, Korsunsky DV, Kulikova OV, Kurekhyan AS, Kutishenko NP, Lavrenova EA, Lopatina MV, Lukina YV, Lukyanov MM, Lyusina EO, Mamedov MN, Mardanov BU, Mareev YV, Martsevich SY, Mitkovskaya NP, Myasnikov RP, Nebieridze DV, Orlov SA, Pereverzeva KG, Popovkina OE, Potievskaya VI, Skripnikova IA, Smirnova MI, Sooronbaev TM, Toroptsova NV, Khailova ZV, Khoronenko VE, Chashchin MG, Chernik TA, Shalnova SA, Shapovalova MM, Shepel RN, Sheptulina AF, Shishkova VN, Yuldashova RU, Yavelov IS, Yakushin SS. Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2024; 23:3696. [DOI: 10.15829/1728-8800-2024-3996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
Создание руководства поддержано Советом по терапевтическим наукам отделения клинической медицины Российской академии наук.
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Gabada R, Yadav V, Nikhade D. Transformative Physiotherapy Approach in an 80-Year-Old Female: A Case Report of Managing Obstructive Sleep Apnea for Improved Quality of Life. Cureus 2024; 16:e57481. [PMID: 38707025 PMCID: PMC11066711 DOI: 10.7759/cureus.57481] [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: 03/12/2024] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
Obstructive sleep apnea (OSA) presents a significant challenge to patients' overall health and well-being, characterized by upper airway collapse during sleep leading to fragmented and non-restorative sleep patterns. This case report describes an 80-year-old female patient presenting with breathlessness, obesity (BMI: 43 kg/m2), sleep disturbances, fatigue, attention deficits, reduced chest compliance, and a history of type 2 diabetes mellitus. Clinical findings revealed ongoing sleep disruptions, worsening breathlessness, progressive weakness, and decreased oxygen saturation levels. The therapeutic intervention involved a comprehensive physiotherapy program targeting respiratory muscle training, lung function improvement, peripheral muscle strengthening, and relaxation exercises. The discussion highlights studies supporting physiotherapeutic interventions such as thoracic extension exercises, neuromuscular stimulation, and oropharyngeal exercises for managing OSA symptoms. Overall, this case underscores the importance of tailored physiotherapy interventions in addressing the multifaceted challenges of OSA, aiming to improve patient outcomes and quality of life.
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Affiliation(s)
- Rishika Gabada
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Vaishnavi Yadav
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Dhanshri Nikhade
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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40
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Zamparelli SS, Lombardi C, Candia C, Iovine PR, Rea G, Vitacca M, Ambrosino P, Bocchino M, Maniscalco M. The Beneficial Impact of Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis: A Review of the Current Literature. J Clin Med 2024; 13:2026. [PMID: 38610791 PMCID: PMC11012394 DOI: 10.3390/jcm13072026] [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: 03/05/2024] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic and irreversible fibrotic disease whose natural history is characterised by a progressive worsening of the pulmonary function, exertional dyspnoea, exercise intolerance, reduced physical activity, and health-related quality of life (HRQOL) impairment. Pulmonary rehabilitation (PR) is a comprehensive, multi-disciplinary programme that uses a combination of strength training, teaching, counselling, and behaviour modification techniques to reduce symptoms and optimise functional capacity in patients with chronic lung disease. Based on the well-documented effectiveness of PR in chronic obstructive pulmonary disease (COPD), over the years supportive evidence of its benefits for other respiratory diseases has been emerging. Although the latest rehabilitation guidelines recognised PR's efficacy for interstitial lung disease (ILD) and IPF in particular, this comprehensive approach remains underused and under-resourced. In this review, we will discuss the advantages and beneficial effects of PR on IPF, analysing its impact on exercise capacity, disease-related symptoms, cardiovascular outcomes, body composition, and HRQOL.
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Affiliation(s)
| | - Carmen Lombardi
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy;
| | - Claudio Candia
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (C.C.); (M.B.)
| | - Paola Rebecca Iovine
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (C.C.); (M.B.)
| | - Gaetano Rea
- Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy;
| | - Michele Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Lumezzane Institute, 25065 Lumezzane, Italy;
| | - Pasquale Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Scientific Directorate of Telese Terme Institute, 82037 Telese Terme, Italy;
| | - Marialuisa Bocchino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (C.C.); (M.B.)
| | - Mauro Maniscalco
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy;
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (C.C.); (M.B.)
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41
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Chuang ML, Wang YH, Lin IF. The contribution of estimated dead space fraction to mortality prediction in patients with chronic obstructive pulmonary disease-a new proposal. PeerJ 2024; 12:e17081. [PMID: 38560478 PMCID: PMC10981412 DOI: 10.7717/peerj.17081] [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: 11/24/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Mortality due to chronic obstructive pulmonary disease (COPD) is increasing. However, dead space fractions at rest (VD/VTrest) and peak exercise (VD/VTpeak) and variables affecting survival have not been evaluated. This study aimed to investigate these issues. Methods This retrospective observational cohort study was conducted from 2010-2020. Patients with COPD who smoked, met the Global Initiatives for Chronic Lung Diseases (GOLD) criteria, had available demographic, complete lung function test (CLFT), medication, acute exacerbation of COPD (AECOPD), Charlson Comorbidity Index, and survival data were enrolled. VD/VTrest and VD/VTpeak were estimated (estVD/VTrest and estVD/VTpeak). Univariate and multivariable Cox regression with stepwise variable selection were performed to estimate hazard ratios of all-cause mortality. Results Overall, 14,910 patients with COPD were obtained from the hospital database, and 456 were analyzed after excluding those without CLFT or meeting the lung function criteria during the follow-up period (median (IQR) 597 (331-934.5) days). Of the 456 subjects, 81% had GOLD stages 2 and 3, highly elevated dead space fractions, mild air-trapping and diffusion impairment. The hospitalized AECOPD rate was 0.60 ± 2.84/person/year. Forty-eight subjects (10.5%) died, including 30 with advanced cancer. The incidence density of death was 6.03 per 100 person-years. The crude risk factors for mortality were elevated estVD/VTrest, estVD/VTpeak, ≥2 hospitalizations for AECOPD, advanced age, body mass index (BMI) <18.5 kg/m2, and cancer (hazard ratios (95% C.I.) from 1.03 [1.00-1.06] to 5.45 [3.04-9.79]). The protective factors were high peak expiratory flow%, adjusted diffusing capacity%, alveolar volume%, and BMI 24-26.9 kg/m2. In stepwise Cox regression analysis, after adjusting for all selected factors except cancer, estVD/VTrest and BMI <18.5 kg/m2 were risk factors, whereas BMI 24-26.9 kg/m2 was protective. Cancer was the main cause of all-cause mortality in this study; however, estVD/VTrest and BMI were independent prognostic factors for COPD after excluding cancer. Conclusions The predictive formula for dead space fraction enables the estimation of VD/VTrest, and the mortality probability formula facilitates the estimation of COPD mortality. However, the clinical implications should be approached with caution until these formulas have been validated.
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Affiliation(s)
- Ming-Lung Chuang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Div. Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - I-Feng Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
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42
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Luo N, Dai F, Wang X, Hu B, Zhang L, Zhao K. Pulmonary Rehabilitation Exercises Effectively Improve Chronic Cough After Surgery for Non-small Cell Lung Cancer. Cancer Control 2024; 31:10732748241255824. [PMID: 38764164 PMCID: PMC11104028 DOI: 10.1177/10732748241255824] [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: 11/20/2023] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/21/2024] Open
Abstract
INTRODUCTION Cough is a major complication after lung cancer surgery, potentially impacting lung function and quality of life. However, effective treatments for managing long-term persistent postoperative cough remain elusive. In this study, we investigated the potential of a pulmonary rehabilitation training program to effectively address this issue. METHODS Between January 2019 and December 2022, a retrospective review was conducted on patients with non-small cell lung cancer (NSCLC) who underwent lobectomy and lymph node dissection via video-assisted thoracoscopic surgery (VATS) at Daping hospital. Based on their postoperative rehabilitation methods, the patients were categorized into 2 groups: the traditional rehabilitation group and the pulmonary rehabilitation group. All patients underwent assessment using the Leicester cough questionnaire (LCQ) on the third postoperative day. Additionally, at the 6-month follow-up, patients' LCQ scores and lung function were re-evaluated to assess the long-term effects of the pulmonary rehabilitation training programs. RESULTS Among the 276 patients meeting the inclusion criteria, 195 (70.7%) were in the traditional rehabilitation group, while 81 (29.3%) participated in the pulmonary rehabilitation group. The pulmonary rehabilitation group showed a significantly lower incidence of cough on the third postoperative day (16.0% vs 29.7%, P = .018) and higher LCQ scores in the somatic dimension (5.09 ± .81 vs 4.15 ± 1.22, P = .007) as well as in the total score (16.44 ± 2.86 vs 15.11 ± 2.51, P = .018, whereas there were no significant differences in psychiatric and sociological dimensions. At the 6-month follow-up, the pulmonary rehabilitation group continued to have a lower cough incidence (3.7% vs 12.8%, P = .022) and higher LCQ scores across all dimensions: somatic (6.19 ± .11 vs 5.75 ± 1.20, P = .035), mental (6.37 ± 1.19 vs 5.85 ± 1.22, P = .002), sociological (6.76 ± 1.22 vs 5.62 ± 1.08, P < .001), and total (18.22 ± 2.37 vs 16.21 ± 2.53, P < .001). Additionally, lung function parameters including FVC, FVC%, FEV1, FEV1%, MVV, MVV%, DLCO SB, and DLCO% were all significantly higher in the pulmonary rehabilitation group compared to the traditional group. CONCLUSION Pulmonary rehabilitation exercises significantly reduced the incidence of postoperative cough and improved cough-related quality of life in patients undergoing lobectomy, with sustained benefits observed at the 6-month follow-up. Additionally, these exercises demonstrated superior lung function outcomes compared to traditional rehabilitation methods.
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Affiliation(s)
- Nanzhi Luo
- Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
- Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Fuqiang Dai
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Xintian Wang
- Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Binbin Hu
- Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Zhang
- Department of Stomatology, Daping Hospital, Army Medical University, Chongqing, China
| | - Kejia Zhao
- Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
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Xu J, Li X, Zeng J, Zhou Y, Li Q, Bai Z, Zhang Y, Xiao J. Effect of Baduanjin qigong on postoperative pulmonary rehabilitation in patients with non-small cell lung cancer: a randomized controlled trial. Support Care Cancer 2023; 32:73. [PMID: 38158422 DOI: 10.1007/s00520-023-08194-4] [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: 03/23/2023] [Accepted: 11/19/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE The purpose of this study was to explore the effect of Baduanjin qigong on improving lung function and postoperative quality of life of patients with non-small cell lung cancer (NSCLC) and to find an effective home-based pulmonary rehabilitation method. METHODS A randomised controlled trial was carried out from July 2019 to October 2021, which included 216 NSCLC postoperative participants from Beijing China-Japan Friendship Hospital and Cancer Hospital of Chinese Academy of Medical Science. Participants were randomly divided into two groups, including the observation (n = 108) group and the control group (n = 108). The control group was given routine lung rehabilitation training, while the observation group was given Baduanjin qigong. Both groups were trained for 12 weeks.The patient's age, sex, smoking history, lung cancer stage, pathological type were recorded. Related indicators of lung function, 6-min walk distance(6MWD), Piper fatigue Scale, and Borg dyspnea score before and after intervention were recorded. RESULTS Compared with these indicators before indicators, lung function, 6MWD, Piper fatigue Scale score and Borg score were significantly better in the two groups after intervention (P < 0.05). There were no significant differences in FVC%, 6MWD and Borg score between the two groups (P > 0.05), whereas FEV1% and Piper fatigue Scale scores in the observation group were better than that in the control group (P < 0.05). CONCLUSION Both Baduanjin qigong and traditional pulmonary rehabilitation methods can improve the postoperative lung function and quality of life of patients with NSCLC; and compared with traditional pulmonary rehabilitation training, Baduanjin Qigong may have certain advantages in relieving cancer-related fatigue and FEV1%, and may be another new method of home-based pulmonary rehabilitation for patients with NSCLC. TRIAL REGISTRATION Clinical Trial No.: ChiCTR1900025121.
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Affiliation(s)
- Jilai Xu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Xia Li
- Guangzhou Special Service Recuperation, Center PLA Rocket Force, Guangzhou, China
| | - Jing Zeng
- Guangzhou Special Service Recuperation, Center PLA Rocket Force, Guangzhou, China
| | - Yanfen Zhou
- Guangzhou Special Service Recuperation, Center PLA Rocket Force, Guangzhou, China
| | - Qiyan Li
- Guangzhou Special Service Recuperation, Center PLA Rocket Force, Guangzhou, China
| | - Zhenmin Bai
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yuxuan Zhang
- Guangzhou Special Service Recuperation, Center PLA Rocket Force, Guangzhou, China.
| | - Jun Xiao
- Guangzhou Special Service Recuperation, Center PLA Rocket Force, Guangzhou, China.
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Yao X, Li J, He J, Zhang Q, Yu Y, He Y, Wu J, Tang W, Ye C. A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China. PLoS One 2023; 18:e0290828. [PMID: 38109304 PMCID: PMC10727440 DOI: 10.1371/journal.pone.0290828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/17/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) has been recognized to be an effective therapy for chronic obstructive pulmonary disease (COPD). However, in China, the application of PR interventions is still less promoted. Therefore, this cross-sectional study aimed to understand COPD patients' intention to receive PR, capture the potential personal, social and environmental barriers preventing their willingness of receiving PR, and eventually identify demanding PR services with the highest priority from patients' point of view. METHODS In total 237 COPD patients were recruited from 8 health care facilities in Zhejiang, China. A self-designed questionnaire was applied to investigate patients' intention to participate in PR and potentially associated factors, including personal dimension such as personal awareness, demographic factors, COPD status and health-related literacy/behaviors, as well as social policies and perceived environmental barriers. The demand questionnaire of PR interventions based on the Kano model was further adopted. RESULTS Among the 237 COPD patients, 75.1% of COPD patients were willing to participate in PR interventions, while only 62.9% of the investigated patients had heard of PR interventions. Over 90% of patients believed that the cost of PR services and the ratio of medical insurance reimbursement were potential obstacles hindering them from accepting PR services. The multiple linear regression analysis indicated that the PR skills of medical staff, knowledge promotion and public education levels of PR in the community, patients' transportation concerns and degree of support from family and friends were significantly associated with willingness of participation in PR interventions. By using the Kano model, the top 9 most-requisite PR services (i.e., one-dimensional qualities) were identified from patients' point of view, which are mainly diet guidance, education interventions, psychological interventions and lower limb exercise interventions. Subgroup analysis also revealed that patients' demographics, such as breathlessness level, age, education and income levels, could influence their choice of priorities for PR services, especially services related to exercise interventions, respiratory muscle training, oxygen therapy and expectoration. CONCLUSIONS This study suggested that PR-related knowledge education among patients and their family, as well as providing basic package of PR services with the most-requisite PR items to COPD patients, were considerable approaches to promote PR attendance in the future.
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Affiliation(s)
- Xinmeng Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jinmei Li
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jialu He
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Qinzhun Zhang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yi Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yinan He
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jinghua Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Weihong Tang
- Department of Gastroenterology, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Chengyin Ye
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
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Mohan A, Iyer VA, Kumar D, Batra L, Dahiya P. Navigating the Post-COVID-19 Immunological Era: Understanding Long COVID-19 and Immune Response. Life (Basel) 2023; 13:2121. [PMID: 38004261 PMCID: PMC10672162 DOI: 10.3390/life13112121] [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: 07/06/2023] [Revised: 09/25/2023] [Accepted: 09/30/2023] [Indexed: 11/26/2023] Open
Abstract
The COVID-19 pandemic has affected the world unprecedentedly, with both positive and negative impacts. COVID-19 significantly impacted the immune system, and understanding the immunological consequences of COVID-19 is essential for developing effective treatment strategies. The purpose of this review is to comprehensively explore and provide insights into the immunological aspects of long COVID-19, a phenomenon where individuals continue to experience a range of symptoms and complications, even after the acute phase of COVID-19 infection has subsided. The immune system responds to the initial infection by producing various immune cells and molecules, including antibodies, T cells, and cytokines. However, in some patients, this immune response becomes dysregulated, leading to chronic inflammation and persistent symptoms. Long COVID-19 encompasses diverse persistent symptoms affecting multiple organ systems, including the respiratory, cardiovascular, neurological, and gastrointestinal systems. In the post-COVID-19 immunological era, long COVID-19 and its impact on immune response have become a significant concern. Post-COVID-19 immune pathology, including autoimmunity and immune-mediated disorders, has also been reported in some patients. This review provides an overview of the current understanding of long COVID-19, its relationship to immunological responses, and the impact of post-COVID-19 immune pathology on patient outcomes. Additionally, the review addresses the current and potential treatments for long COVID-19, including immunomodulatory therapies, rehabilitation programs, and mental health support, all of which aim to improve the quality of life for individuals with long COVID-19. Understanding the complex interplay between the immune system and long COVID-19 is crucial for developing targeted therapeutic strategies and providing optimal care in the post-COVID-19 era.
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Affiliation(s)
- Aditi Mohan
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida Sector-125, Noida 201313, Uttar Pradesh, India; (A.M.); (V.A.I.)
| | - Venkatesh Anand Iyer
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida Sector-125, Noida 201313, Uttar Pradesh, India; (A.M.); (V.A.I.)
| | - Dharmender Kumar
- Department of Biotechnology, Deenbandhu Chhotu Ram University of Science &Technology, Murthal, Sonipat 131309, Haryana, India;
| | - Lalit Batra
- Regional Biocontainment Laboratory, Center for Predictive Medicine, University of Louisville, Louisville, KY 40222, USA
| | - Praveen Dahiya
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida Sector-125, Noida 201313, Uttar Pradesh, India; (A.M.); (V.A.I.)
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Luo K, Huang YQ, Zhu LB, Gan XR, Zhang Y, Xiao SN, Zhou RP, Chen JW, Liu JM, Liu ZL. Risk Factors and Nomogram for Postoperative Pulmonary Infection in Patients with Cervical Spinal Cord Injury. World Neurosurg 2023; 177:e317-e324. [PMID: 37343670 DOI: 10.1016/j.wneu.2023.06.040] [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: 04/03/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To identify the risk factors for developing postoperative pulmonary infection in patients with acute cervical spinal cord injury (CSCI), and to develop a nomogram prediction model. METHODS Patients with CSCI who were admitted to 3 different medical centers between July 2011 and July 2021 were included in this study. All patients underwent cervical spine surgery. Data for patients admitted to the first 2 centers were included in a training set to establish the nomogram prediction model, and data for patients admitted to the third center were included in a validation set to externally verify the efficacy of the prediction model. For the training set, patients were divided into an infected group and a noninfected group (control group). Independent risk factors for postoperative pulmonary infection in patients with CSCI were identified by univariate and multivariate logistic regression analyses. Additionally, a nomogram prediction model was developed and validated based on the risk factors. RESULTS A total of 689 patients were enrolled, including 574 for the training set and 115 for the validation set. Of the patients included for the training set, 144 developed pulmonary infection, with an incidence of 25.09%; 40 patients included for the validation set developed pulmonary infection (34.78%). Multivariate logistic regression analysis showed that age, American Spinal Injury Association grade, steroid pulse, high-level injury, smoking, multistage surgery, and operation duration were risk factors for the development of postoperative pulmonary infection in patients with CSCI. The area under the curve of the receiver operating characteristic curve of the model built by the training set was 0.905, and that of the receiver operating characteristic curve of the verification set was 0.917. The decision curve indicated that the model was in the range 1%-100%, and the predicted net benefit value of the model was high. CONCLUSIONS Age, American Spinal Injury Association grade, steroid pulse, CSCI site, smoking history, number of surgical levels, and surgical duration are correlated with the development of postoperative pulmonary infection in patients with CSCI. The risk prediction model of postoperative pulmonary infection has a good prediction efficiency and accuracy.
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Affiliation(s)
- Kun Luo
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China
| | - Yong-Quan Huang
- Department of Spine and Spinal Cord, Pingxiang People's Hospital, Pingxiang, PR China
| | - Liang-Bo Zhu
- Department of Orthopedic Surgery, Yichun People's Hospital, Yichun, PR China
| | - Xin-Rong Gan
- Department of Orthopedic Surgery, Yichun People's Hospital, Yichun, PR China
| | - Yu Zhang
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China
| | - Shi-Ning Xiao
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China
| | - Rong-Ping Zhou
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China
| | - Jiang-Wei Chen
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China
| | - Jia-Ming Liu
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China
| | - Zhi-Li Liu
- Medical Innovation Center, the First Affiliated Hospital of Nanchang University, Nanchang, PR China; Institute of Spine and Spinal Cord, Nanchang University, Nanchang, PR China.
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Hu W, Wu WN, Qiao Q. Occupational survey-based evidence of health status and welfare problems of workers with pneumoconiosis in China. Front Public Health 2023; 11:1142161. [PMID: 37719739 PMCID: PMC10501603 DOI: 10.3389/fpubh.2023.1142161] [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: 01/11/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Background Pneumoconiosis is the most dangerous occupational disease in China. According to unofficial records, nearly million migrant workers were affected by pneumoconiosis in 2011, with the number increasing annually. Among them, a large number of migrant workers suffering from pneumoconiosis were not medically diagnosed. Therefore, fundamental questions remain unanswered: what is the background of workers who receive a diagnosis of pneumoconiosis, and how does pneumoconiosis affect their future and well-being? Methods In this study, we identified and surveyed 1,134 workers with pneumoconiosis in seven selected regions in China with substantially high incidences of pneumoconiosis by using a combination of cluster sampling, convenience sampling, and snowball sampling. We used demographic, medical, and rehabilitation conditions and welfare questionnaires to collect the data. Results The findings highlighted the socioeconomic status of patients with pneumoconiosis. The majority of workers with pneumoconiosis were adult men who had received no higher education, who lived in rural households, and who were employed in mining or manufacturing industries. Among these workers, 52.8% had been exposed to dust at work for more than 10 years, and 53.1% received a diagnosis of stage II or III pneumoconiosis. More than half of the workers (569 workers, 50.2%) did not receive comprehensive, routine treatment; 33.4% (379 workers) visited a doctor when they experienced physical discomfort, and 6.6% (75 workers) never received treatment. Only 156 workers (13.8%) received rehabilitation services, whereas 978 workers (86.2%) never did. The study results also revealed the severe financial difficulties faced by patients with pneumoconiosis. Only 208 workers (18.3%) had access to work-related injury insurance, with the cost of pneumoconiosis treatment being a substantial burden for 668 workers (60.6%). Conclusion In this study, we explored the existing health and welfare problems faced by workers with pneumoconiosis in China and identified the social injustice and health disparities that these workers experience. We also clarified the primary challenges in implementing safety, health, and welfare policies for these workers and those who are exposed to high-risk environments, such as those working in mining.
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Affiliation(s)
- Wenxiu Hu
- Centre for Population and Development Policy Studies, Fudan University, Shanghai, China
| | - Wei-Ning Wu
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Qingmei Qiao
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
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Kubincová A, Takáč P, Demjanovič Kendrová L, Joppa P. Predictors of Quality-of-Life Improvement at Different Minimum Clinically Important Difference Values in Patients with Chronic Obstructive Pulmonary Disease after Climatic Rehabilitation Treatment. Life (Basel) 2023; 13:1763. [PMID: 37629620 PMCID: PMC10455286 DOI: 10.3390/life13081763] [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: 06/30/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The minimum clinically important difference (MCID) for the St George's Respiratory Questionnaire (SGRQ) is debated in chronic obstructive pulmonary disease (COPD) quality-of-life (QoL) assessments. This study aimed to determine whether there is a difference in predictors of clinically significant improvement between the traditional (value of 4) and newly proposed MCID SGRQ (value of 7) after climatic rehabilitation treatment. Climatic rehabilitation treatment consists of two main parts: climatotherapy, which typically involves the controlled exposure of individuals to natural environmental elements, and climatic rehabilitation, which includes other therapeutic factors such as physical activities as well as educating the patient to change their lifestyle. METHODS This study included 90 consecutive patients diagnosed with COPD who underwent structured complex pulmonary rehabilitation in High Tatras, part of the Carpathian Mountains. The examination before and after treatment included spirometry, QoL assessment using the SGRQ, 6 min walk test (6-MWT), and the Borg, Beck and Zung scale. RESULTS Patients showed statistically significant improvement after the intervention in FEV1, FEV1/FVC, 6-MWT, (p < 0.001), anxiety scores, depression, and improvement in dyspnoea both before and after the 6-MWT (p < 0.001). For both MCID for SGRQ levels 4 and 7, we confirmed the same predictors of clinical improvement for bronchial obstruction grade (spirometry) and exercise capacity (6-MWT), for quality of life in activity score and total score. CONCLUSION The results suggest that both the proposed MCID for SGRQ values could be sufficient to assess the clinical significance of the achieved change in health status when assessing the need for pulmonary rehabilitation comprising climatotherapy in patients with COPD.
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Affiliation(s)
- Anna Kubincová
- Department of Physical Medicine, Balneology and Medical Rehabilitation, Medical Faculty of P. J. Šafárik University and L. Pasteur University Hospital in Košice, 04190 Košice, Slovakia;
| | - Peter Takáč
- Department of Physical Medicine, Balneology and Medical Rehabilitation, Medical Faculty of P. J. Šafárik University and L. Pasteur University Hospital in Košice, 04190 Košice, Slovakia;
| | | | - Pavol Joppa
- Department of Pneumology and Phtiseology, Medical Faculty of P. J. Šafárik University and L. Pasteur University Hospital in Košice, 04190 Košice, Slovakia;
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Rochester CL, Alison JA, Carlin B, Jenkins AR, Cox NS, Bauldoff G, Bhatt SP, Bourbeau J, Burtin C, Camp PG, Cascino TM, Dorney Koppel GA, Garvey C, Goldstein R, Harris D, Houchen-Wolloff L, Limberg T, Lindenauer PK, Moy ML, Ryerson CJ, Singh SJ, Steiner M, Tappan RS, Yohannes AM, Holland AE. Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2023; 208:e7-e26. [PMID: 37581410 PMCID: PMC10449064 DOI: 10.1164/rccm.202306-1066st] [Citation(s) in RCA: 126] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Background: Despite the known benefits of pulmonary rehabilitation (PR) for patients with chronic respiratory disease, this treatment is underused. Evidence-based guidelines should lead to greater knowledge of the proven benefits of PR, highlight the role of PR in evidence-based health care, and in turn foster referrals to and more effective delivery of PR for people with chronic respiratory disease. Methods: The multidisciplinary panel formulated six research questions addressing PR for specific patient groups (chronic obstructive pulmonary disease [COPD], interstitial lung disease, and pulmonary hypertension) and models for PR delivery (telerehabilitation, maintenance PR). Treatment effects were quantified using systematic reviews. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations: The panel made the following judgments: strong recommendations for PR for adults with stable COPD (moderate-quality evidence) and after hospitalization for COPD exacerbation (moderate-quality evidence), strong recommendation for PR for adults with interstitial lung disease (moderate-quality evidence), conditional recommendation for PR for adults with pulmonary hypertension (low-quality evidence), strong recommendation for offering the choice of center-based PR or telerehabilitation for patients with chronic respiratory disease (moderate-quality evidence), and conditional recommendation for offering either supervised maintenance PR or usual care after initial PR for adults with COPD (low-quality evidence). Conclusions: These guidelines provide the basis for evidence-based delivery of PR for people with chronic respiratory disease.
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Tonga KO, Oliver BG. Effectiveness of Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease Therapy: Focusing on Traditional Medical Practices. J Clin Med 2023; 12:4815. [PMID: 37510930 PMCID: PMC10381859 DOI: 10.3390/jcm12144815] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex and serious disease that is characterized by dyspnea, fatigue, decreased exercise tolerance, peripheral muscle dysfunction, and mood disorders. These manifestations are successfully treated with pulmonary rehabilitation, a comprehensive intervention and holistic approach designed to improve the physical and psychological condition of people with COPD. Exercise is a big component of pulmonary rehabilitation programs, but the efficacy of non-traditional forms of exercise as used in alternative medicine is poorly understood. Here, we aim to address this gap in knowledge and summarize the clinical evidence for the use of traditional exercise regimens in the pulmonary rehabilitation of COPD patients.
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Affiliation(s)
- Katrina O Tonga
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, Macquarie University, Glebe, NSW 2037, Australia
- Saint Vincent's Hospital Sydney, Darlinghurst, NSW 2010, Australia
| | - Brian G Oliver
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, Macquarie University, Glebe, NSW 2037, Australia
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
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