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Spiesshoefer J, Herkenrath SD, Treml M, Pietzke-Calcagnile A, Hagmeyer L, Regmi B, Matthes S, Young P, Boentert M, Randerath WJ. Inspiratory Muscle Dysfunction Mediates and Predicts a Disease Continuum of Hypercapnic Failure in Chronic Obstructive Pulmonary Disease. Respiration 2024; 103:182-192. [PMID: 38325348 DOI: 10.1159/000536589] [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: 07/19/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Advanced chronic obstructive pulmonary disease (COPD) is associated with chronic hypercapnic failure. The present work aimed to comprehensively investigate inspiratory muscle function as a potential key determinant of hypercapnic respiratory failure in patients with COPD. METHODS Prospective patient recruitment encompassed 61 stable subjects with COPD across different stages of respiratory failure, ranging from normocapnia to isolated nighttime hypercapnia and daytime hypercapnia. Arterialized blood gas analyses and overnight transcutaneous capnometry were used for patient stratification. Assessment of respiratory muscle function encompassed body plethysmography, maximum inspiratory pressure (MIP), diaphragm ultrasound, and transdiaphragmatic pressure recordings following cervical magnetic stimulation of the phrenic nerves (twPdi) and a maximum sniff manoeuvre (Sniff Pdi). RESULTS Twenty patients showed no hypercapnia, 10 had isolated nocturnal hypercapnia, and 31 had daytime hypercapnia. Body plethysmography clearly distinguished patients with and without hypercapnia but did not discriminate patients with isolated nocturnal hypercapnia from those with daytime hypercapnia. In contrast to ultrasound parameters and transdiaphragmatic pressures, only MIP reflected the extent of hypercapnia across all three stages. MIP values below -48 cmH2O predicted nocturnal hypercapnia (area under the curve = 0.733, p = 0.052). CONCLUSION In COPD, inspiratory muscle dysfunction contributes to progressive hypercapnic failure. In contrast to invasive tests of diaphragm strength only MIP fully reflects the pathophysiological continuum of hypercapnic failure and predicts isolated nocturnal hypercapnia.
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Affiliation(s)
- Jens Spiesshoefer
- Department of Pneumology and Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany
- Interdisciplinary Health Science Center, Scuola Superiore Sant Anna Pisa, Pisa, Italy
| | - Simon D Herkenrath
- Institute for Pneumology at the University of Cologne, Solingen, Germany
- Bethanien Hospital gGmbH, Solingen, Germany
| | - Marcel Treml
- Institute for Pneumology at the University of Cologne, Solingen, Germany,
| | | | - Lars Hagmeyer
- Institute for Pneumology at the University of Cologne, Solingen, Germany
- Bethanien Hospital gGmbH, Solingen, Germany
| | - Binaya Regmi
- Department of Pneumology and Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Sandhya Matthes
- Institute for Pneumology at the University of Cologne, Solingen, Germany
| | - Peter Young
- Medical Park Klinik Reithofpark, Bad Feilnbach, Germany
| | - Matthias Boentert
- Department of Neurology with Institute for Translational Neurology, University of Muenster, Muenster, Germany
- Department of Medicine, UKM Marienhospital Steinfurt, Steinfurt, Germany
| | - Winfried J Randerath
- Institute for Pneumology at the University of Cologne, Solingen, Germany
- Bethanien Hospital gGmbH, Solingen, Germany
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Tian Z, Jiang Y, Zhang N, Zhang Z, Wang L. Analysis of the Current State of COPD Nursing Based on a Bibliometric Approach from the Web of Science. Int J Chron Obstruct Pulmon Dis 2024; 19:255-268. [PMID: 38283691 PMCID: PMC10813247 DOI: 10.2147/copd.s440715] [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: 09/17/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024] Open
Abstract
Background and Aim COPD nursing plays a crucial role in alleviating disease symptoms, prolonging patient survival, and is therefore of paramount importance. However, authoritative research findings, research hotspots, and development trends in the field of COPD are still unclear. This study aimed to examine authoritative research findings, research hotspots, and trends in the field of COPD nursing. Descriptive statistics and bibliometric and visual analyses of the literature were conducted. Methods Bibliometric data were obtained from the Web of Science database. Citespace was used to explore publication trends, countries, institutions, journals, authors, keywords, and co-citation characteristics of the included literature in order to summarize the key research in the field of COPD nursing. Results In total, 693 articles on COPD nursing were published. 1998-2014 showed a rapid growth period in this research field, which stabilized in 2015-2022. The research content could mostly be summarized into five categories: acute exacerbation, quality of life, risk, evidence-based nursing, and pulmonary rehabilitation. The research hotspots in 1998-2014 included randomized controlled trials, education, elderly patients, nursing home residents, nursing homes, rehabilitation, and prevalence. Research in 2015-2022 focused on impact, palliative care, needs, and predictors. In recent years, research mainly concentrated on symptom management models, cost-effectiveness, and cumulative meta-analysis. Conclusion Bibliometric analysis of COPD nursing articles indicates that the focus of COPD nursing research is shifting from tertiary prevention to primary and secondary prevention. Helping patients achieve self-management of symptoms, reducing the financial burden of COPD on healthcare, and summarizing research evidence by meta-analyses will likely remain the focus of future research.
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Affiliation(s)
- Zheng Tian
- School of Nursing, Tianjin Medical University, Tianjin, 300070, People’s Republic of China
| | - Yachen Jiang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, People’s Republic of China
| | - Nan Zhang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, People’s Republic of China
| | - Zhijun Zhang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Lan Wang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, People’s Republic of China
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Chai X, Wu L, He Z. Effects of virtual reality-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: A meta-analysis. Medicine (Baltimore) 2023; 102:e36702. [PMID: 38206693 PMCID: PMC10754576 DOI: 10.1097/md.0000000000036702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Virtual reality (VR)-based pulmonary rehabilitation has been used in the management of chronic obstructive pulmonary disease (COPD). The efficacy of VR-based pulmonary rehabilitation for improving lung function in patients with COPD is controversial. Therefore, the aim of this meta-analysis was to evaluate the efficacy of VR combined with pulmonary rehabilitation for lung function in patients with COPD. METHODS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was performed in the Cochrane Library, EMBASE, Web of Science, PubMed, and China National Knowledge Infrastructure databases from inception to February 1, 2023. All included studies were randomized controlled trials that assessed VR combined with pulmonary rehabilitation for COPD patients. The effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (CI). The Cochrane Collaboration tool was used to assess the risk of bias. Publication bias was assessed by Egger test. RESULTS A total of 11 studies met the inclusion criteria and were included in this study. The combined effect size showed that VR combined with pulmonary rehabilitation was more effective than pulmonary rehabilitation alone at improving forced expiratory volume in 1 second% (SMD: 0.51; 95% CI 0.19,0.82; P = .002), forced expiratory volume in 1 second/forced vital capacity (SMD: 0.71; 95% CI 0.49,0.93; P < .001), dyspnea (SMD: -0.44; 95% CI -0.66, -0.22; P < .001), and 6-minute walking test (SMD: 059; 95% CI 0.39, 0.79; P < .001). In addition, the VR combined with pulmonary rehabilitation improved depression (SMD: -0.34; 95% CI -0.05, -0.03; P = .033) and anxiety mood (SMD: -0.57; 95% CI -1.11, -0.04; P = .036) compared with the pulmonary rehabilitation group. CONCLUSION This meta-analysis indicated that VR regimens could be used to enhance the therapeutic effect of pulmonary rehabilitation in patients with COPD. However, as a rapidly evolving field, more well-designed randomized controlled trials are needed to determine the impact of VR-based pulmonary rehabilitation on COPD patients.
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Affiliation(s)
- Xiuqin Chai
- Department of Pulmonary and Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, China
| | - Lingyun Wu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhihong He
- Department of Pulmonary and Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, China
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Kostorz-Nosal S, Jastrzębski D, Błach A, Skoczyński S. Window of opportunity for respiratory oscillometry: A review of recent research. Respir Physiol Neurobiol 2023; 316:104135. [PMID: 37536553 DOI: 10.1016/j.resp.2023.104135] [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: 05/31/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/05/2023]
Abstract
Oscillometry has been around for almost 70 years, but there are still many unknowns. The test is performed during tidal breathing and is therefore free from patient-dependent factors that could influence the results. The Forced Oscillation Technique (FOT), which requires minimal patient cooperation, is gaining ground, particularly with elderly patients and children. In pulmonology, it is a valuable tool for assessing obstructive conditions (with a distinction between central and peripheral obstruction) and restrictive disorders (intrapulmonary and extrapulmonary). Its sensitivity allows the assessment of bronchodilator and bronchoconstrictor responses. Different lung diseases show different patterns of changes in FOT, especially studied in asthma and chronic obstructive pulmonary disease. Because of these differences, many studies have analysed the usefulness of this technique in different areas of medicine. In this paper, the authors would like to present the basics of oscillometry with the areas of its most recent clinical applications.
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Affiliation(s)
- Sabina Kostorz-Nosal
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-803 Zabrze, Poland.
| | - Dariusz Jastrzębski
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-803 Zabrze, Poland
| | - Anna Błach
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Szymon Skoczyński
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-803 Zabrze, Poland
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Chen KY, Kuo HY, Lee KY, Feng PH, Wu SM, Chuang HC, Chen TT, Sun WL, Tseng CH, Liu WT, Cheng WH, Majumdar A, Stettler M, Tsai CY, Ho SC. Associations of the distance-saturation product and low-attenuation area percentage in pulmonary computed tomography with acute exacerbation in patients with chronic obstructive pulmonary disease. Front Med (Lausanne) 2023; 9:1047420. [PMID: 36687440 PMCID: PMC9846059 DOI: 10.3389/fmed.2022.1047420] [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: 09/18/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) has high global health concerns, and previous research proposed various indicators to predict mortality, such as the distance-saturation product (DSP), derived from the 6-min walk test (6MWT), and the low-attenuation area percentage (LAA%) in pulmonary computed tomographic images. However, the feasibility of using these indicators to evaluate the stability of COPD still remains to be investigated. Associations of the DSP and LAA% with other COPD-related clinical parameters are also unknown. This study, thus, aimed to explore these associations. Methods This retrospective study enrolled 111 patients with COPD from northern Taiwan. Individuals' data we collected included results of a pulmonary function test (PFT), 6MWT, life quality survey [i.e., the modified Medical Research Council (mMRC) scale and COPD assessment test (CAT)], history of acute exacerbation of COPD (AECOPD), and LAA%. Next, the DSP was derived by the distance walked and the lowest oxygen saturation recorded during the 6MWT. In addition, the DSP and clinical phenotype grouping based on clinically significant outcomes by previous study approaches were employed for further investigation (i.e., DSP of 290 m%, LAA% of 20%, and AECOPD frequency of ≥1). Mean comparisons and linear and logistic regression models were utilized to explore associations among the assessed variables. Results The low-DSP group (<290 m%) had significantly higher values for the mMRC, CAT, AECOPD frequency, and LAA% at different lung volume scales (total, right, and left), whereas it had lower values of the PFT and 6MWT parameters compared to the high-DSP group. Significant associations (with high odds ratios) were observed of the mMRC, CAT, AECOPD frequency, and PFT with low- and high-DSP groupings. Next, the risk of having AECOPD was associated with the mMRC, CAT, DSP, and LAA% (for the total, right, and left lungs). Conclusion A lower value of the DSP was related to a greater worsening of symptoms, more-frequent exacerbations, poorer pulmonary function, and more-severe emphysema (higher LAA%). These readily determined parameters, including the DSP and LAA%, can serve as indicators for assessing the COPD clinical course and may can serve as a guide to corresponding treatments.
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Affiliation(s)
- Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Hsiao-Yun Kuo
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,School of Respiratory Therapy, College of Medicine, Taipei Medical University, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Wei-Lun Sun
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chien-Hua Tseng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan,Division of Critical Care Medicine, Department of Emergency and Critical Care Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Wen-Te Liu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Research Center of Artificial Intelligence in Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Wun-Hao Cheng
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Marc Stettler
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Cheng-Yu Tsai
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom,Cheng-Yu Tsai,
| | - Shu-Chuan Ho
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,School of Respiratory Therapy, College of Medicine, Taipei Medical University, New Taipei City, Taiwan,*Correspondence: Shu-Chuan Ho,
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Relationship of Exercise Capacity, Physical Function, and Frailty Measures With Clinical Outcomes and Healthcare Utilization in Lung Transplantation: A Scoping Review. Transplant Direct 2022; 8:e1385. [PMID: 36246000 PMCID: PMC9553387 DOI: 10.1097/txd.0000000000001385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2022] Open
Abstract
Measures of exercise capacity, frailty, and physical function are commonly used in lung transplant candidates and recipients to evaluate their physical limitations and the effects of exercise training and to select candidates for transplantation. It is unclear how these measures are related to clinical outcomes and healthcare utilization before and after lung transplantation. The purpose of this scoping review was to describe how measures of exercise capacity, physical function, and frailty are related to pre- and posttransplant outcomes.
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Wu MF, Teng CM, Kuo TH, Huang WC, Wen CY. A Pervasive Pulmonary Function Estimation System with Six-Minute Walking Test. BIOSENSORS 2022; 12:824. [PMID: 36290960 PMCID: PMC9599376 DOI: 10.3390/bios12100824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Self-monitoring for spirometry is beneficial to assess the progression of lung disease and the effect of pulmonary rehabilitation. However, home spirometry fails to meet both accuracy and repeatability criteria in a satisfactory manner. The study aimed to propose a pervasive spirometry estimation system with the six-minute walking test (6MWT), where the system with information management, communication protocol, predictive algorithms, and a wrist-worn device, was developed for pulmonary function. A total of 60 subjects suffering from respiratory diseases aged from 25 to 90 were enrolled in the study. Pulmonary function test, walking steps, and physical status were measured before and after performing the 6MWT. The significant variables were extracted to predict per step distance (PSD), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). These predicted formulas were then implemented in a wrist-worn device of the proposed pervasive estimation system. The predicted models of PSD, and FVC, FEV1 with the 6MWT were created. The estimated difference for PSD was-0.7 ± 9.7 (cm). FVC and FEV1 before performing 6MWT were 0.2 ± 0.6 (L) and 0.1 ± 0.6 (L), respectively, and with a sensitivity (Sn) of 81.8%, a specificity (Sp) of 63.2% for obstructive lung diseases, while FVC and FEV1 after performing the 6MWT were 0.2 ± 0.7 (L) and 0.1 ± 0.6 (L), respectively, with an Sn of 90.9% and an Sp of 63.2% for obstructive lung diseases. Furthermore, the developed wristband prototype of the pulmonary function estimation system was demonstrated to provide effective self-estimation. The proposed system, consisting of hardware, application and algorithms was shown to provide pervasive assessment of the pulmonary function status with the 6MWT. This is a potential tool for self-estimation on FVC and FEV1 for those who cannot conduct home-based spirometry.
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Affiliation(s)
- Ming-Feng Wu
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung 407, Taiwan
| | - Chi-Min Teng
- Department of Electrical Engineering, National Chung Hsing University, Taichung 402, Taiwan
| | - Tz-Hau Kuo
- Department of Electrical Engineering, National Chung Hsing University, Taichung 402, Taiwan
| | - Wei-Chang Huang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan
- Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 350, Taiwan
| | - Chih-Yu Wen
- Department of Electrical Engineering, National Chung Hsing University, Taichung 402, Taiwan
- Bachelor Program of Electrical Engineering and Computer Science, Innovation and Development Center of Sustainable Agriculture (IDCSA), National Chung Hsing University, Taichung 402, Taiwan
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Romero D, Blanco-Almazán D, Groenendaal W, Lijnen L, Smeets C, Ruttens D, Catthoor F, Jané R. Predicting 6-minute walking test outcomes in patients with chronic obstructive pulmonary disease without physical performance measures. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 225:107020. [PMID: 35905697 DOI: 10.1016/j.cmpb.2022.107020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/20/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) requires a multifactorial assessment, evaluating the airflow limitation and symptoms of the patients. The 6-min walk test (6MWT) is commonly used to evaluate the functional exercise capacity in these patients. This study aims to propose a novel predictive model of the major 6MWT outcomes for COPD assessment, without physical performance measurements. METHODS Cardiopulmonary and clinical parameters were obtained from fifty COPD patients. These parameters were used as inputs of a Bayesian network (BN), which integrated three multivariate models including the 6-min walking distance (6MWD), the maximum HR (HRmax) after the walking, and the HR decay 3 min after (HRR3). The use of BN allows the assessment of the patients' status by predicting the 6MWT outcomes, but also inferring disease severity parameters based on actual patient's 6MWT outcomes. RESULTS Firstly, the correlation obtained between the estimated and actual 6MWT measures was strong (R = 0.84, MAPE = 8.10% for HRmax) and moderate (R = 0.58, MAPE = 15.43% for 6MWD and R = 0.58, MAPE = 32.49% for HRR3), improving the classical methods to estimate 6MWD. Secondly, the classification of disease severity showed an accuracy of 78.3% using three severity groups, which increased up to 84.4% for two defined severity groups. CONCLUSIONS We propose a powerful two-way assessment tool for COPD patients, capable of predicting 6MWT outcomes without the need for an actual walking exercise. This model-based tool opens the way to implement a continuous monitoring system for COPD patients at home and to provide more personalized care.
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Affiliation(s)
- Daniel Romero
- Universitat Politecnica de Catalunya · BarcelonaTech (UPC), Barcelona 08019, Spain; Institute for Bioengineering of Catalonia (IBEC-BIST), Barcelona 08019, Spain; Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid 28029, Spain.
| | - Dolores Blanco-Almazán
- Universitat Politecnica de Catalunya · BarcelonaTech (UPC), Barcelona 08019, Spain; Institute for Bioengineering of Catalonia (IBEC-BIST), Barcelona 08019, Spain; Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid 28029, Spain
| | | | | | | | | | | | - Raimon Jané
- Universitat Politecnica de Catalunya · BarcelonaTech (UPC), Barcelona 08019, Spain; Institute for Bioengineering of Catalonia (IBEC-BIST), Barcelona 08019, Spain; Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid 28029, Spain
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Lyu R, Wang W, Wang W, Liu N, Xiao J, Li X. Effect of humidified high-flow nasal cannula oxygen therapy on respiratory function recovery in stable COPD patients. Am J Transl Res 2022; 14:4074-4081. [PMID: 35836894 PMCID: PMC9274567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the effect of humidified high-flow nasal cannula oxygen therapy (HFNC) on the application effect and respiratory functional recovery of stable COPD patients. METHODS The data of 116 patients with stable COPD treated in our hospital from March 2019 to January 2021 were analyzed retrospectively. Among them, 54 patients treated with conventional oxygen therapy (COT) were enrolled into the control group (CG), and the remaining 62 treated with HFNC were divided to the experimental group (EG). The clinical efficacy and adverse reactions of both groups were assessed, and the blood gas analysis indexes pH, PaO2, PaCO2, respiratory function indexes FEV1, FEV1%, FEV1/FVC, quality of life and motor recovery were compared. RESULTS After treatment, compared with the CG, the FEV1, FEV1% and FEV1/FVC in the EG were obviously higher (P<0.05). Besides, the pH and PaO2 in the EG were markedly higher (P<0.05), while PaCO2 was lower (P<0.05). The total effective rate, SGRQ scores and 6MWT in the EG were markedly higher than those in the CG (P<0.05), while the incidence of adverse reactions in the EG was lower (P<0.05). CONCLUSION HFNC can improve respiratory function and quality of life of stable COPD patients, with higher safety.
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Affiliation(s)
- Ruibing Lyu
- Department of PCCM, CR & WISCO General Hospital, Wuhan University of Science and TechnologyNo. 29, Metallurgical Avenue, Qingshan District, Wuhan 430080, Hubei Province, P. R. China
| | - Wen Wang
- Department of Rehabilitation, CR & WISCO General Hospital, Wuhan University of Science and TechnologyNo. 29, Metallurgical Avenue, Qingshan District, Wuhan 430080, Hubei Province, P. R. China
| | - Wenju Wang
- Department of PCCM, CR & WISCO General Hospital, Wuhan University of Science and TechnologyNo. 29, Metallurgical Avenue, Qingshan District, Wuhan 430080, Hubei Province, P. R. China
| | - Nian Liu
- Department of Clinical Medicine, School of Medicine, Wuhan University of Science and Technology50 m Northeast of The Intersection of Heping Avenue and Xueyuan Road, Wuhan 430080, Hubei Province, P. R. China
| | - Jinwen Xiao
- Department of PCCM, CR & WISCO General Hospital, Wuhan University of Science and TechnologyNo. 29, Metallurgical Avenue, Qingshan District, Wuhan 430080, Hubei Province, P. R. China
| | - Xin Li
- Department of PCCM, CR & WISCO General Hospital, Wuhan University of Science and TechnologyNo. 29, Metallurgical Avenue, Qingshan District, Wuhan 430080, Hubei Province, P. R. China
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Ozsoy I, Kodak MI, Zerman N, Kararti C, Erturk A. The optimal cut-off points of 4-meter gait speed to discriminate functional exercise capacity and health status in elderly patients with chronic obstructive pulmonary disease. Ann Geriatr Med Res 2022; 26:156-161. [PMID: 35728930 PMCID: PMC9271394 DOI: 10.4235/agmr.22.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background Gait speed, a vital sign of health and functional capacity, is commonly used to measure mobility. Although studies have assessed gait speed in older adults and individuals with chronic obstructive pulmonary disease (COPD) separately, few have evaluated gait speed in older adults with COPD. Therefore, the primary objective of our study was to determine the threshold point for the 4-meter gait speed test (4MGS) to better discriminate between functional exercise capacity and health status in older patients with COPD. The second objective was to determine possible predictors of gait speed. Methods In this cross-sectional study, we assessed participants’ pulmonary function, dyspnea, health status (COPD Assessment Test [CAT]), gait speed (4MGS), functional exercise capacity (6-minute walk test [6MWT]), and physical activity. Results Forty-five older patients with COPD participated in this study. The predicted 6MWT and CAT scores were independent and significant determinants of the 4MGS score, explaining 54% of the variance (p<0.001). We identified gait speeds of 0.96 m/s and 1.04 m/s as thresholds to predict abnormal functional exercise capacity (sensitivity 85% and specificity 56%) and impaired health status (sensitivity 90% and specificity 69%), respectively (p<0.05). Conclusion Our findings demonstrated that gait speed can discriminate between abnormal functional exercise capacity and impaired health status in older patients with COPD. Moreover, functional exercise capacity and health status are predictors of gait speed.
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Affiliation(s)
- Ismail Ozsoy
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Selcuk University, Konya, Turkey
- Corresponding Author: Ismail Ozsoy, PhD Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Selcuk University, Akademi Mah. Yeni İstanbul Cad. No:369, Konya 42130, Turkey E-mail:
| | - Muhammed Ihsan Kodak
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Nermin Zerman
- Department of Chest Disease, Faculty of Medicine, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Caner Kararti
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Arzu Erturk
- Department of Chest Disease, Faculty of Medicine, Kırsehir Ahi Evran University, Kırsehir, Turkey
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Müller K, Zwingmann K, Auerswald T, Berger I, Thomas A, Schultz AL, Wilhelm E, Weber RC, Kolb F, Wastlhuber A, Meder S, Stegbauer M. Rehabilitation and Return-to-Work of Patients Acquiring COVID-19 in the Workplace: A Study Protocol for an Observational Cohort Study. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:754468. [PMID: 36188830 PMCID: PMC9397694 DOI: 10.3389/fresc.2021.754468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/20/2021] [Indexed: 11/15/2022]
Abstract
Background In 2020, the novel coronavirus disease (COVID-19) developed into a worldwide pandemic. The course of COVID-19 is diverse, non-specific, and variable: Affected persons suffer from physical, cognitive, and psychological acute and long-term consequences. The symptoms influence everyday life activities, as well as work ability in the short or long-term. Healthcare professionals are considered particularly vulnerable to COVID-19 compared to the general population. In Germany, COVID-19 is recognized as an occupational disease or a work-related accident under certain conditions. Disease-specific rehabilitation is recommended for patients following acute COVID-19 to recover physical and neuropsychological performance and to improve work ability. Currently, there are limited findings on the short-term or long-term impact of COVID-19 as a recognized occupational disease or work-related accident, as well as on rehabilitation programs and associated influencing factors. Thus, the present research project will investigate these questions. Methods For this observational cohort study, post-acute patients with COVID-19 as a recognized occupational disease or work-related accident according to the insurance regulations for COVID-19 will be recruited at the BG Hospital for Occupational Disease in Bad Reichenhall, Germany. All participants will complete a comprehensive multimodal and interdisciplinary inpatient rehabilitation program for a duration of at least 3 weeks, beginning after their acute COVID-19 infection and depending on their individual indication and severity of disease. Participants will complete medical, functional, motor, psychological, and cognitive measurements at four time points (at the beginning (T1) and end (T2) of inpatient rehabilitation; 6 (T3) and 12 (T4) months after the beginning of inpatient rehabilitation). Discussion The present research project will help to assess and describe long-term effects of COVID-19 as a recognized occupational disease or work-related accident on physical and neuropsychological health, as well as on everyday activities and work ability of affected insured persons. In addition, this study will investigate influencing factors on severity and course of COVID-19. Furthermore, we will examine rehabilitation needs, measures, occurring specifics, and the feasibility of the rehabilitation procedure and disease development in the patients. The results of the intended study will further advance common recommendations for targeted and tailored rehabilitation management and participation in inpatient rehabilitation. Clinical Trial Registration www.drks.de, identifier: DRKS00022928.
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Affiliation(s)
- Katrin Müller
- Department of Social Science of Physical Activity and Health, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Katharina Zwingmann
- Department of Social Science of Physical Activity and Health, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Tina Auerswald
- Department of Social Science of Physical Activity and Health, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Ivo Berger
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Andreas Thomas
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Anna-Lena Schultz
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Eva Wilhelm
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | | | - Franziska Kolb
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Alois Wastlhuber
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Sylvia Meder
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Michael Stegbauer
- BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
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12
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Yilmaz B, Maden C, Turhan B. The effects of breathing exercises on respiratory functions, functional capacity and quality of life in vehicle spray painters. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2021.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Workers engaged in vehicle spray painting are at a risk of developing respiratory problems because of the solvents in the spray paints. Changes in respiratory functions and functional capacities caused by spray painting can be improved with respiratory exercises. The aim of this study was to examine the effects of respiratory exercises on the respiratory functions, functional capacity and quality of life in vehicle spray painters. Methods A total of 70 volunteers with similar characteristics participated in the study. The groups were divided into two groups randomly (35 study group, 35 control group). Respiratory functions (value of forced expiratory volume percentage in 1 second [FEV1]), forced vital capacity percentage [FVC], FEV1/FVC percentage, peak expiratory flow percentage [PEF (%)] and maximum voluntary ventilation percentage [MVV (%)]), functional capacity (6-Minute Walk Test) and quality of life (Short Form Health Survey [SF-36]) were evaluated. The study group undertook supervised breathing exercises 3 days a week for 6 weeks. The same exercises were given to the control group as a home programme. Home programmes were followed up by telephone calls. Evaluations were performed again after 6 weeks. Results In the study group, FEV1 (%) increased more than in the control group (P<0.05). The increase in PEF (%) was similar in both groups (P>0.05). In the study group, FEV1/FVC (%) and MVV (%) were significantly different before and after the intervention (P<0.05), but there was no difference in the control group (P>0.05). There was a greater increase in the study group than in the control group (P<0.05). 6-Minute Walk Test distance (m) before and after the intervention in both groups were similar (P>0.05). Before and after the intervention, a significant difference was found in the vitality and the social function domains of the SF-36 in the study group. In the comparisons of groups, a significant difference was found in the study group in the role-emotional, social function and bodily pain domains of the SF-36 after the intervention (P<0.05). Conclusions Breathing exercises can be recommended for vehicle spray painters to avoid an increase in respiratory resistance and to improve their quality of life.
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Affiliation(s)
- Burak Yilmaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Cagtay Maden
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Begümhan Turhan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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13
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Flora S, Hipólito N, Brooks D, Marques A, Morais N, Silva CG, Silva F, Ribeiro J, Caceiro R, Carreira BP, Burtin C, Pimenta S, Cruz J, Oliveira A. Phenotyping Adopters of Mobile Applications Among Patients With COPD: A Cross-Sectional Study. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:729237. [PMID: 36188799 PMCID: PMC9397739 DOI: 10.3389/fresc.2021.729237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022]
Abstract
Effectiveness of technology-based interventions to improve physical activity (PA) in people with COPD is controversial. Mixed results may be due to participants' characteristics influencing their use of and engagement with mobile health apps. This study compared demographic, clinical, physical and PA characteristics of patients with COPD using and not using mobile apps in daily life. Patients with COPD who used smartphones were asked about their sociodemographic and clinic characteristics, PA habits and use of mobile apps (general and PA-related). Participants performed a six-minute walk test (6MWT), gait speed test and wore an accelerometer for 7 days. Data were compared between participants using (App Users) and not using (Non-App Users) mobile apps. A sub-analysis was conducted comparing characteristics of PA–App Users and Non-Users. 59 participants were enrolled (73% Male; 66.3 ± 8.3 yrs; FEV1 48.7 ± 18.4% predicted): 59% were App Users and 25% were PA-App Users. Significant differences between App Users and Non-App Users were found for age (64.2 ± 8.9 vs. 69.2 ± 6.3yrs), 6MWT (462.9 ± 91.7 vs. 414.9 ± 82.3 m), Gait Speed (Median 1.5 [Q1–Q3: 1.4–1.8] vs. 2.0 [1.0–1.5]m/s), Time in Vigorous PA (0.6 [0.2–2.8] vs. 0.14 [0.1–0.7]min) and Self-Reported PA (4.0 [1.0–4.0] vs. 1.0 [0.0–4.0] Points). Differences between PA–App Users and Non-Users were found in time in sedentary behavior (764.1 [641.8–819.8] vs. 672.2 [581.2–749.4] min) and self-reported PA (4.0 [2.0–6.0] vs. 2.0 [0.0–4.0] points). People with COPD using mobile apps were younger and had higher physical capacity than their peers not using mobile apps. PA-App Users spent more time in sedentary behaviors than Non-Users although self-reporting more time in PA.
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Affiliation(s)
- Sofia Flora
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Nádia Hipólito
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Nuno Morais
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Cândida G. Silva
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Department of Chemistry, Coimbra Chemistry Centre, University of Coimbra, Coimbra, Portugal
| | - Fernando Silva
- School of Technology and Management, Computer Science and Communications Research Centre, Polytechnic Institute of Leiria, Leiria, Portugal
| | - José Ribeiro
- School of Technology and Management, Computer Science and Communications Research Centre, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Rúben Caceiro
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Technology and Management, Computer Science and Communications Research Centre, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Bruno P. Carreira
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Unidade de Saúde Familiar Pedro e Inês, ACeS Oeste Norte, Alcobaça, Portugal
| | - Chris Burtin
- Faculty of Rehabilitation Sciences, REVAL—Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- BIOMED—Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Sara Pimenta
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- *Correspondence: Joana Cruz
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
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Targeting exertional breathlessness to improve physical activity: the role of primary care. NPJ Prim Care Respir Med 2021; 31:41. [PMID: 34504091 PMCID: PMC8429707 DOI: 10.1038/s41533-021-00254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/19/2021] [Indexed: 02/08/2023] Open
Abstract
Primary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients' avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.
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15
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Zhang Y, Meng X, Shen Y, Xie J, Yu X, Wang Q, Wang L. The Reliability and Validity of the Brief ICF Core Set in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:2077-2087. [PMID: 34290501 PMCID: PMC8289296 DOI: 10.2147/copd.s306410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze the reliability and validity of the Brief international classification of functioning, disability and health (ICF) core set for chronic obstructive pulmonary disease (COPD). Patients and Methods A cross-sectional study was conducted in four tertiary hospitals in Tianjin, China. A total of 100 patients with COPD were selected to evaluate functioning and disability involving body functions, body structures, activities and participation as well as environmental factors of the Brief ICF core set for COPD. Internal consistency was calculated by Cronbach's α. Content validity was examined using the content validity index (CVI), scale-level CVI/universal agreement, and scale-level CVI/average agreement (S-CVI/Ave). In addition, construct validity and convergent validity were also examined. Results The Brief ICF core set for COPD had a high internal consistency, 0.873 for the total scale, with values of 0.750, 0.640, and 0.843 for body functions, body structures, and activity and participation, respectively. The content validity was calculated by the CVI, scale-level CVI/universal agreement, and S-CVI/Ave at values of 0.80-1, 0.929, and 0.986, respectively. Meanwhile, the ICF core set for COPD had good convergent validity, correlating with the mMRC dyspnea score (r=0.690, P<0.01), and there were significant correlations between the ICF core set for COPD and COPD clinical severity grade (r=0.363, P<0.01). A four-factor model of functions and disability in the Brief ICF core set for COPD had the best fit according to confirmatory factor analysis (CFA). Conclusion The Brief ICF core set for COPD is a reliable and valid convenient instrument for assessing comprehensive problems in the functioning of patients with COPD, which can be used to design and to evaluate rehabilitation strategies.
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Affiliation(s)
- Yongmei Zhang
- School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoxuan Meng
- School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yuehao Shen
- Department of Respiratory Care, General Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Jiajia Xie
- Department of Respiratory Care, General Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Xi Yu
- Department of Respiratory Care, Tianjin First Center Hospital, Tianjin, People's Republic of China
| | - Qiaoshuo Wang
- Department of Cardiac Care, Tianjin Chest Hospital, Tianjin, People's Republic of China
| | - Lan Wang
- School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China
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16
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Yamamoto A, Shirai T, Hirai K, Tanaka Y, Watanabe H, Endo Y, Shimoda Y, Suzuki T, Noguchi R, Mochizuki E, Sakurai S, Saigusa M, Akamatsu T, Shishido Y, Akita T, Morita S, Asada K. Oscillometry as a Predictor of Exercise Tolerance in COPD. COPD 2020; 17:647-654. [PMID: 33183076 DOI: 10.1080/15412555.2020.1844176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The usefulness of the oscillometry, known as forced oscillation technique, for predicting exercise tolerance in subjects with COPD is unknown. To test the hypothesis, we investigated whether oscillometry could predict a 6-minute walking distance (6MWD) <350 m in the 6-minute walk test (6MWT).This was a prospective, observational study. Fifty-seven subjects with COPD who attended outpatient clinics for routine checkups at Shizuoka General Hospital between April 2015 and April 2016 (54 males; median age, 70 years; and %FEV1, 61.0%). Modified MRC dyspnea scale (mMRC), COPD Assessment Test (CAT), oscillometry, spirometry, and 6MWT were performed in a stable condition. The participants were classified into subjects with 6MWD ≥350 m or 6MWD <350 m, and the predictor of 6MWD <350 m was assessed.Of the 57 total subjects, 43 (75.4%) had a 6MWD ≥350 m, and 14 (24.6%) had a 6MWD <350 m. Between the two groups, there were significant differences in mMRC scale, GOLD stages, CAT scores, FEV1, IC, 6MWD, lowest SpO2, maximum Borg scale, respiratory resistance (Rrs), and reactance (Xrs). In multivariate regression analysis, a 6MWD <350 m was independently predicted by CAT scores (OR 1.15, 95% CI: 1.01-1.30) and inspiratory R5 (OR 6.01, 95% CI: 1.09-33.30). In receiver operating characteristic curves, the area under the curve was 0.76, 0.78, and 0.85 for CAT scores, R5, and CAT scores + R5, respectively, with the best cutoff value of 17 and 2.82 cmH20/L/s. In conclusion, the oscillatory parameter, inspiratory R5, predicted low exercise tolerance in COPD subjects.
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Affiliation(s)
- Akito Yamamoto
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Keita Hirai
- Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Yuko Tanaka
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Hirofumi Watanabe
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Yoshinari Endo
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Yukiko Shimoda
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Takahito Suzuki
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Rie Noguchi
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Eisuke Mochizuki
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Shogo Sakurai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Mika Saigusa
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Taisuke Akamatsu
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Yuichiro Shishido
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Takefumi Akita
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Satoru Morita
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
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Kang K, Meng X, Li B, Yuan J, Tian E, Zhang J, Zhang W. Effect of thoracic paravertebral nerve block on the early postoperative rehabilitation in patients undergoing thoracoscopic radical lung cancer surgery. World J Surg Oncol 2020; 18:298. [PMID: 33183325 PMCID: PMC7664097 DOI: 10.1186/s12957-020-02071-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 10/27/2020] [Indexed: 12/31/2022] Open
Abstract
Objective To evaluate the effect of thoracic paravertebral nerve block on early postoperative rehabilitation in patients undergoing radical thoracoscopic surgery for lung cancer. Methods Ninety patients scheduled for elective video-assisted thoracoscopic lobectomy of lung cancer were divided into 2 groups: the general anesthesia group (GA group, n = 45) and the TPVB group (TP group, n = 45). The primary outcome was the decline rate of the 6-min walking test (6MWT); the second outcomes were as follows: absolute value and the completion rate of 6MWT, postoperative analgesia deficiency and pain scores, oxycodone consumption, sleep quality, the incidence of postoperative pulmonary complications, and the hospital stay. Results Compared with the GA group, the TP group had a lower decline rate of the 6MWT on POD1 and POD2. The walking distance on POD1 and POD2 in the TP group was significantly longer than that in the GA group; the completion rate at POD1 in the TP group was higher than that in the GA group. The pain scores and oxycodone consumption at POD1 in the TP group were lower than the GA group. The sleep quality in the TP group was higher than the GA group. Conclusions TPVB can significantly improve postoperative rehabilitation in patients undergoing thoracoscopic radical lung cancer surgery, which is helpful for promoting the early recovery of patients. Trial registration Chinese Clinical Trial Registry, ChiCTR1900026213. Registered 26 Sept. 2019, http://www.chictr.org.cn/showproj.aspx?proj=43733.
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Affiliation(s)
- Kang Kang
- Department of Perioperative Medicine and Anesthesiology, Henan University People's Hospital; Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China
| | - Xing Meng
- Department of Perioperative Medicine and Anesthesiology, Henan University People's Hospital; Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China
| | - Bing Li
- Department of Perioperative Medicine and Anesthesiology, Henan University People's Hospital; Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China
| | - Jingli Yuan
- Department of Perioperative Medicine and Anesthesiology, Henan University People's Hospital; Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China
| | - Erhu Tian
- Department of Cardiology, Henan University People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China
| | - Jiaqiang Zhang
- Department of Perioperative Medicine and Anesthesiology, Henan University People's Hospital; Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China
| | - Wei Zhang
- Department of Perioperative Medicine and Anesthesiology, Henan University People's Hospital; Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China.
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Xiao L, Duan H, Li P, Wu W, Shan C, Liu X. A systematic review and meta-analysis of Liuzijue in stable patients with chronic obstructive pulmonary disease. BMC Complement Med Ther 2020; 20:308. [PMID: 33054800 PMCID: PMC7557061 DOI: 10.1186/s12906-020-03104-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/05/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To investigate the effectiveness of Liuzijue exercise on chronic obstructive pulmonary disease (COPD) in the stable phase. METHODS We searched six electronic bibliographic databases (PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, and Wan Fang Data) from inception to August 2018. Randomized controlled trials (RCTs) were included if they evaluated the effect of Liuzijue exercise on stable COPD. Cochrane Collaboration risk-of-bias tool (Cochrane Handbook 5.1.0) was used to assess the risk of bias of included RCTs. Meta-analysis was performed using the Review Manager software (RevMan V.5.3.5) provided by the Cochrane Collaboration. Outcomes assessed included dyspnea, exercise capacity, lung function, and quality of life. RESULTS Fourteen RCTs involving 920 stable COPD patients were included in this systematic review and meta-analysis. The control groups received usual care. The average number of training sessions per participant was 9.3 per week, and the average length of these training sessions was 31.6 min per week. Training duration varied from 3 to 12 months. Meta-analysis results showed that Liuzijue exercise can effectively improve patients' Modified Medical Research Council Dyspnea Scale scores (MD = - 0.73, 95% CI: - 1.13 to - 0.33, P < 0.05), 6MWD (MD = 17.78, 95% CI: 7.97 to 27.58, P < 0.05), forced expiratory volume in one second (FEV1) (MD = 0.23, 95% CI: 0.07 to 0.38, P < 0.05), the percentage of predicted values of FEV1 (FEV1%pred) (MD = 7.59, 95% CI: 2.92 to 12.26, P < 0.05), FEV1/FVC (Forced vital capacity) ratio (MD = 6.81, 95% CI: 3.22 to 10.40, P < 0.05), Quality of life: St. George's Respiratory Questionnaire total score (MD = - 9.85, 95%CI: - 13.13 to - 6.56, P < 0.05), and Chronic Obstructive Pulmonary Disease Assessment Test score (MD = - 2.29, 95%CI: - 3.27, - 1.30, P < 0.05). CONCLUSION Evidence from meta-analysis suggested that Liuzijue exercise could improve dyspnea, exercise endurance, lung function, and quality of life for stable COPD patients. However, owing to the methodological bias and the placebo effect of Liuzijue exercise, there is a need for further research to confirm these findings. TRIAL REGISTRATION PROSPERO (ID: CRD42019130973 ).
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Affiliation(s)
- Lu Xiao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Hongxia Duan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peijun Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Chunlei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
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Wang K, Liang ZY, Wang XL, Li Y, Lu YR, Liu JF, Li JH, Xu LM, Chen GQ, Chang P, Cen ZR, Chen X. Continuous positive airway pressure improves respiratory mechanics and efficiency of neural drive in stable COPD: an exploratory study. J Thorac Dis 2020; 12:626-638. [PMID: 32274128 PMCID: PMC7139021 DOI: 10.21037/jtd.2019.12.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Continuous positive airway pressure (CPAP) is a major treatment strategy for severe chronic obstructive pulmonary disease (COPD), especially with respiratory failure. However, it remains inconclusive whether CPAP affects respiratory mechanics and neural drive in stable COPD patients without respiratory failure. Methods Twenty-two COPD patients without respiratory failure received CPAP starting from 4 to 10 cmH2O in 1 cmH2O increments. Respiratory pattern, end expiatory lung volume (EELV), dynamic PEEPi (PEEPidyn), airway resistance (Raw), pressure-time product of diaphragmatic pressure (PTPdi) and esophageal pressure (PTPeso), root mean square (RMS) of diaphragm electromyogram (EMGdi) and ratio of ventilation (Ve) to EMGdi (i.e., Ve/RMS) were measured before and at each level of continue positive airway pressure (CPAP). A subgroup analysis was performed between patients with and without inspiratory muscle weakness. Results Nineteen patients completed the treatment. The respiratory pattern improved significantly after CPAP. Raw, PTPdi, and Pdi decreased significantly. ΔEELV decreased at 4 cmH2O (P<0.05), but increased significantly at >8 cmH2O. PEEPidyn decreased from 2.18±0.98 to 1.37±0.55 cmH2O. RMS increased while Ve/RMS improved significantly after CPAP (P<0.05). Besides, CPAP could significantly improve respiratory mechanics in patients with inspiratory muscle weakness. Conclusions CPAP improves respiratory pattern, PEEPi, Raw, work of breathing and efficiency of neural drive in COPD patients without respiratory failure, but easily increases dynamic pulmonary hyperinflation. These effects on respiratory mechanics are significant in patients with inspiratory muscle weakness.
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Affiliation(s)
- Kai Wang
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.,Department of Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Zhen-Yu Liang
- Department of Respiratory Medicine, The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xi-Long Wang
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Yun Li
- Department of Respiratory Medicine, Gaozhou People's Hospital, Guangdong 525200, China
| | - Yi-Rong Lu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Jun-Fang Liu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Jia-Hui Li
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Li-Mei Xu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Guo-Qiang Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Ping Chang
- Department of Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Zhong-Ran Cen
- Department of Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Xin Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
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20
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TUDORACHE E, MOTOC NS, PESCARU C, CRISAN A, CIUMARNEAN L. Impact of pulmonary rehabilitation programs in improving health status in COPD patients. BALNEO RESEARCH JOURNAL 2019. [DOI: 10.12680/balneo.2019.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pulmonary rehabilitation programme (PRP) have a positive impact on multiple outcomes of COPD, such as decreasing symptoms, increasing exercise tolerance and improving general health status. The aim of this study is to evaluate exercise tolerance impairment and to assess the impact of PRP in improving health status in patients diagnosed with COPD. It was conducted a prospective parallel group study in the Pulmonary Rehabilitation Department of the Clinical Hospital "V. Babes”, Timisoara, from 2007 to 2010. The subjects included in the study were patients diagnosed with COPD stages I-IV GOLD, initially evaluated and started a PRP, then re-evaluated after 3 weeks and 6 months. The study group included 168 patients, 158 men, mean age 61.73 years. The initial evaluation revealed higher values of dyspnea scores using mMRC scale in advanced COPD stages (3.69±0.77 in patients with COPD stage IV, vs 0.88±0.5 in patients with COPD stage, p<0.05), decreased Forced expiratory volume in 1 second (FEV1), PImax and PEmax, and 6 minutes walking distance values corresponding with COPD severity stages. Re-evaluation at 3 weeks and 6 months after the pulmonary rehabilitation programme was applied showed significant improved dyspnea scores and exercise tolerance. The results of this study reconfirmed the positive and persistent impact of pulmonary rehabilitation programme on muscle dysfunction, dyspnea, and quality of life in COPD patients, regardless of severity. Key words: COPD, pulmonary rehabilitation programme, 6 minutes walking test, pedometry,
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Affiliation(s)
| | | | - Camelia PESCARU
- “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Alexandru CRISAN
- “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Lorena CIUMARNEAN
- „Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
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21
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Liu X, Li P, Wang Z, Lu Y, Li N, Xiao L, Duan H, Wang Z, Li J, Shan C, Wu W. Evaluation of isokinetic muscle strength of upper limb and the relationship with pulmonary function and respiratory muscle strength in stable COPD patients. Int J Chron Obstruct Pulmon Dis 2019; 14:2027-2036. [PMID: 31564850 PMCID: PMC6733348 DOI: 10.2147/copd.s214737] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/15/2019] [Indexed: 11/23/2022] Open
Abstract
Background Upper limb muscle strength plays an important role in respiratory and pulmonary function, and limited research focuses on the role of strength and endurance of the elbow extensor and flexor. This study was conducted to accurately assess upper limb muscle function and quantified associations with pulmonary function and respiratory muscle strength in patients with stable chronic obstructive pulmonary disease (COPD). Methods In this cross-sectional study, patients with stable COPD treated in Yue-Yang Integrative Medicine Hospital from March 2014 to March 2016 were recruited. All participants underwent a pulmonary function test (forced expiratory volume in first second/forced vital capacity, FEV1/FVC; percentage value of predicted FEV1, FEV1%pred), a respiratory muscle strength test (maximal inspiratory pressure, MIP; maximal expiratory pressure, MEP), and an isokinetic test of dominant upper limb after a 24-hr interval (peak torque, PT; PT/body weight, PT/BW; total work, TW; endurance ratio, ER). Results A total of 88 patients with stable COPD (age: 65.5±8.7 years) were recruited, of which 73% (64 patients) were male. In the multiple stepwise regression analysis, sex remained as significant impactors in the final model for FEV1%pred (adjusted R2=0.243, P<0.001). Elbow flexor PT/BW and ER, sex, and BMI remained as significant impactors in the final model for FEV1/FVC (adjusted R2=0.255, P<0.01). Elbow flexor TW remained as significant impactors for MIP (adjusted R2=0.112, P=0.001), while elbow extensor PT and PT/BW and sex remained as significant impactors for MEP (adjusted R =0.385, P<0.01). Conclusion In stable COPD, pulmonary function and respiratory muscle strength are associated with upper limb muscle strength. In particular, elbow flexor endurance is likely an important impactor for pulmonary function and inspiratory muscle strength, while elbow extensor strength is of importance for expiratory muscle strength.
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Affiliation(s)
- Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.,Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Peijun Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Zhenwei Wang
- Department of Respiratory Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, People's Republic of China
| | - Yufan Lu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Ning Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Lu Xiao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Hongxia Duan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Zhengrong Wang
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Jian Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Chunlei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.,Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, People's Republic of China
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