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Boote C, Ma Q, Goh KL. Age-dependent mechanical properties of tail tendons in wild-type and mimecan gene-knockout mice - A preliminary study. J Mech Behav Biomed Mater 2023; 139:105672. [PMID: 36657194 DOI: 10.1016/j.jmbbm.2023.105672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/03/2023] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Abstract
Mimecan, or osteoglycin, belongs to the family of small leucine-rich proteoglycans. In connective tissues mimecan is implicated in the development and maintenance of normal collagen fibrillar organization. Since collagen fibrils are responsible for tissue reinforcement, the absence of mimecan could lead to abnormal tissue mechanical properties. Here, we carried out a preliminary investigation of possible changes in the mechanical properties of tendons in mice lacking a functional mimecan gene, as a function of age. Tail tendons were dissected from mimecan gene knockout (KO) and wild type (WT) mice at ages 1, 4 and 8 months and mechanical properties evaluated using a microtensile testing equipment. Mimecan gene knockout resulted in changes in tendon elasticity- and fracture-related properties. While tendons of WT mice exhibited enhanced mechanical properties with increasing age, this trend was notably attenuated in mimecan KO tendons, with the exception of fracture strain. When genotype and age were considered as cross factors, the diminution in the mechanical properties of mimecan KO tendons was significant for yield strength, modulus and fracture strength. This effect appeared to affect the mice at 4 month old. These preliminary results suggest that mimecan may have a role in regulating age-dependent mechanical function in mouse tail tendon.
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Affiliation(s)
- C Boote
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK; Department of Biomedical Engineering, National University of Singapore, Singapore; Newcastle Research and Innovation Institute (NewRIIS), Singapore
| | - Q Ma
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - K L Goh
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK; Newcastle Research and Innovation Institute (NewRIIS), Singapore; Faculty of Science, Agriculture and Engineering, Newcastle University, Newcastle Upon Tyne, UK.
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Cox NS, Lahham A, McDonald CF, Mahal A, O'Halloran P, Hepworth G, Spencer L, McNamara RJ, Bondarenko J, Macdonald H, Gavin S, Burge AT, Le Maitre C, Ringin C, Webb E, Nichols A, Tsai LL, Luxton N, van Hilten S, Santos M, Crute H, Byrne M, Boursinos H, Broe J, Corbett M, Marceau T, Warrick B, Boote C, Melinz J, Holland AE. Home-based pulmonary rehabilitation early after hospitalisation in COPD (early HomeBase): protocol for a randomised controlled trial. BMJ Open Respir Res 2021; 8:e001107. [PMID: 34819323 PMCID: PMC8614151 DOI: 10.1136/bmjresp-2021-001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/05/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is characterised by exacerbations of respiratory disease, frequently requiring hospital admission. Pulmonary rehabilitation can reduce the likelihood of future hospitalisation, but programme uptake is poor. This study aims to compare hospital readmission rates, clinical outcomes and costs between people with COPD who undertake a home-based programme of pulmonary rehabilitation commenced early (within 2 weeks) of hospital discharge with usual care. METHODS A multisite randomised controlled trial, powered for superiority, will be conducted in Australia. Eligible patients admitted to one of the participating sites for an exacerbation of COPD will be invited to participate. Participants will be randomised 1:1. Intervention group participants will undertake an 8-week programme of home-based pulmonary rehabilitation commencing within 2 weeks of hospital discharge. Control group participants will receive usual care and a weekly phone call for attention control. Outcomes will be measured by a blinded assessor at baseline, after the intervention (week 9-10 posthospital discharge), and at 12 months follow-up. The primary outcome is hospital readmission at 12 months follow-up. ETHICS AND DISSEMINATION Human Research Ethics approval for all sites provided by Alfred Health (Project 51216). Findings will be published in peer-reviewed journals, conferences and lay publications. TRIAL REGISTRATION NUMBER ACTRN12619001122145.
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Affiliation(s)
- Narelle S Cox
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Melbourne, Victoria, Australia
| | - Aroub Lahham
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
| | - Christine F McDonald
- Institute for Breathing and Sleep, Melbourne, Victoria, Australia
- Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Ajay Mahal
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul O'Halloran
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Graham Hepworth
- Statistical Consulting Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - Lissa Spencer
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | | | - Janet Bondarenko
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | | | - Samantha Gavin
- Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia
| | - Angela T Burge
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | | | - Cade Ringin
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Elizabeth Webb
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Amanda Nichols
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
| | - Ling-Ling Tsai
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Prince of Wales Hospital, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Nia Luxton
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
| | - Stephanie van Hilten
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
| | - Mary Santos
- Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Hayley Crute
- Wimmera Health Care Group, Horsham, Victoria, Australia
| | - Megan Byrne
- Wimmera Health Care Group, Horsham, Victoria, Australia
| | - Helen Boursinos
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
| | - Jennifer Broe
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
| | - Monique Corbett
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Tunya Marceau
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Brooke Warrick
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Wimmera Health Care Group, Horsham, Victoria, Australia
| | | | - Joanna Melinz
- Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia
| | - Anne E Holland
- Respiratory Research@Alfred, Department of Immunology & Pathology, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
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Barker K, Holland AE, Lee AL, Haines T, Ritchie K, Boote C, Saliba J, Lowe S, Pazsa F, Thomas L, Turczyniak M, Skinner EH. Multimorbidity rehabilitation versus disease-specific rehabilitation in people with chronic diseases: a pilot randomized controlled trial. Pilot Feasibility Stud 2018; 4:181. [PMID: 30519483 PMCID: PMC6267787 DOI: 10.1186/s40814-018-0369-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 11/13/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Multimorbidity (the co-existence of two or more chronic conditions in an individual) is a growing healthcare burden internationally; however, healthcare and disease management, including rehabilitation, is often delivered in single-disease siloes. The aims of this study were to (1) evaluate the safety and feasibility of multimorbidity rehabilitation compared to a disease-specific rehabilitation program in people with multimorbidity and (2) gather preliminary data regarding clinical outcomes and resource utilization to inform the design of future trials. METHODS A pilot feasibility randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Seventeen individuals with a chronic disease eligible for disease-specific rehabilitation (pulmonary, cardiac, heart failure rehabilitation) and at least one other chronic condition were recruited. The intervention group attended multimorbidity exercise rehabilitation and the control group attended disease-specific exercise rehabilitation. Participants attended twice-weekly exercise training and weekly education for 8 weeks. Feasibility measures included numbers screened, recruited, and completed. Other outcome measures were change in functional exercise capacity (6-minute walk test (6MWT)), health-related quality of life (HRQoL), activities of daily living (ADL), and resource utilization. RESULTS Sixty-one people were screened to recruit seventeen participants (nine intervention, eight control); one withdrew prior to rehabilitation. Participants were mostly male (63%) with a mean (SD) age of 69 (9) years and body mass index of 29 (6). The intervention group attended a mean (SD) of 12 (6) sessions, and the control group attended 11 (4) sessions. One participant (6%) withdrew after commencing; two (12%) were lost to follow-up. The intervention group 6MWT distance increased by mean (SD) of 22 (45) meters (95% confidence interval - 16 to 60) compared to 22 (57) meters (95% confidence interval - 69 to 114) (control). CONCLUSIONS It was feasible to recruit people with multimorbidity to a randomized controlled trial of rehabilitation. A large RCT with the power to make significant conclusions about the impact on the primary and secondary outcomes is now required. TRIAL REGISTRATION The trial was registered with the Australian and New Zealand Clinical Trials Registry available at http://www.anzctr.org.au ACTRN12614001186640. Registered 12/11/2014.
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Affiliation(s)
- Kathryn Barker
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
| | - Anne E. Holland
- La Trobe University, Plenty Rd and Kingsbury Drive, Bundoora, Victoria 3086 Australia
- Alfred Health, 55 Commercial Rd, Melbourne, Victoria 3004 Australia
- Institute for Breathing and Sleep, Bowen Centre, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084 Australia
| | - Annemarie L. Lee
- La Trobe University, Plenty Rd and Kingsbury Drive, Bundoora, Victoria 3086 Australia
- Institute for Breathing and Sleep, Bowen Centre, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084 Australia
- School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, The University of Melbourne, Melbourne, Victoria 3000 Australia
| | - Terry Haines
- Allied Health Research Unit, Faculty of Medicine Nursing and Health Science, Monash University, Frankston, Victoria 3199 Australia
| | - Kathryn Ritchie
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
| | - Claire Boote
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
- Alfred Health, 55 Commercial Rd, Melbourne, Victoria 3004 Australia
| | - Joanne Saliba
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050 Australia
| | - Stephanie Lowe
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
| | - Fiona Pazsa
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
| | - Lee Thomas
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
| | - Monica Turczyniak
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
| | - Elizabeth H. Skinner
- Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
- Australian Institute of Musculoskeletal Science, Western Centre for Health Research and Education, Western Health, St Albans, Victoria 3021 Australia
- Allied Health Research Unit, Faculty of Medicine Nursing and Health Science, Monash University, Frankston, Victoria 3199 Australia
- School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, The University of Melbourne, Melbourne, Victoria 3000 Australia
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Barker K, Holland AE, Lee AL, Ritchie K, Boote C, Lowe S, Pazsa F, Thomas L, Turczyniak M, Skinner EH. A rehabilitation programme for people with multimorbidity versus usual care: A pilot randomized controlled trial. J Comorb 2018; 8:2235042X18783918. [PMID: 30057892 PMCID: PMC6060614 DOI: 10.1177/2235042x18783918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/25/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multimorbidity, the coexistence of two or more chronic conditions, is common in clinical practice. Rehabilitation for people with multimorbidity may provide access to a rehabilitation programme that can address common symptoms and risk factors for multiple chronic diseases. OBJECTIVE The aims of this study were to (1) evaluate the feasibility of a rehabilitation programme compared to usual medical care (UMC) in people with multimorbidity and (2) gather preliminary data regarding clinical effects and impact on functional exercise capacity, activities of daily living, health-related quality of life and resource utilization. DESIGN A pilot feasibility parallel randomized controlled trial was undertaken. Adults with multimorbidity were randomized to the rehabilitation programme (intervention) or UMC (control). The duration of the rehabilitation programme was 8 weeks and comprised exercise (1 h, twice weekly) and education (1 h, once weekly). The UMC group did not participate in a structured exercise programme. RESULTS One hundred people were screened to recruit 16 participants, with a 71% completion rate for the intervention group. The rehabilitation group achieved a mean (standard deviation) improvement in 6-minute walk distance of 44 (41) m and the UMC group of 23 (29) m. CONCLUSIONS This study suggests that it would be feasible to conduct a larger randomized control trial investigating a rehabilitation programme for people with multimorbidity. Low uptake of the study suggests that refinement of the inclusion criteria, recruitment sources and programme model will be needed to achieve the number of participants required.
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Affiliation(s)
- Kathryn Barker
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
| | - Anne E Holland
- Discipline of Physiotherapy, La Trobe University, Bundoora,
Victoria, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria,
Australia
- Institute for Breathing and Sleep, Bowen Centre, Austin Health,
Heidelberg, Victoria, Australia
| | - Annemarie L Lee
- Discipline of Physiotherapy, La Trobe University, Bundoora,
Victoria, Australia
- Institute for Breathing and Sleep, Bowen Centre, Austin Health,
Heidelberg, Victoria, Australia
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health
Science, School of Primary and Allied Health Care, Monash University, Frankston,
Victoria, Australia
| | - Kathryn Ritchie
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
| | - Claire Boote
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria,
Australia
| | - Stephanie Lowe
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
| | - Fiona Pazsa
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
| | - Lee Thomas
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
| | - Monica Turczyniak
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
| | - Elizabeth H Skinner
- Department of Physiotherapy and Community Services, Western Health,
176 Furlong Road, St Albans, Victoria, Australia
- Australian Institute of Musculoskeletal Science, Western Centre for
Health Research and Education, Western Health, Victoria, Australia
- Allied Health Research Unit, Faculty of Medicine, Nursing and Health
Science, Monash University, Frankston, Victoria, Australia
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health
Sciences, Melbourne School of Health Sciences, The University of Melbourne,
Victoria, Australia
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Dowman LM, McDonald CF, Hill CJ, Lee AL, Barker K, Boote C, Glaspole I, Goh NSL, Southcott AM, Burge AT, Gillies R, Martin A, Holland AE. The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial. Thorax 2017; 72:610-619. [DOI: 10.1136/thoraxjnl-2016-208638] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 12/21/2022]
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Dowman L, McDonald CF, Hill CJ, Lee A, Barker K, Boote C, Glaspole I, Goh N, Southcott A, Burge A, Ndongo R, Martin A, Holland AE. Reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease. Physiotherapy 2015; 102:249-55. [PMID: 26596172 DOI: 10.1016/j.physio.2015.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 10/05/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the inter-rater and intra-rater reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease (ILD). DESIGN Test retest reliability of hand-held dynamometry for elbow flexor and knee extensor strength between two independent raters and two testing sessions. SETTING Physiotherapy department within a tertiary hospital. PARTICIPANTS Thirty participants with ILD of varying aetiology were included. Twenty participants completed the inter-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean (SD) age 73 (10) years, 11 male) and 21 participants completed the intra-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean age 71 (10) years, 11 male). MAIN OUTCOME MEASURES Mean muscle strength (kg). Agreement between the two raters and testing sessions was analyzed using Bland-Altman plots and reliability was estimated using intraclass correlation coefficients (ICC). RESULTS For elbow flexor strength there was a mean difference between raters of -0.6kg (limits of agreement (LOA) -5.6 to 4.4kg) and within raters of -0.3kg (LOA -2.8 to 2.3kg). The ICCs were 0.95 and 0.98, respectively. For knee extensor strength there was a mean difference between raters of -1.5kg (LOA -6.9 to 3.9kg) and within raters of -0.7kg (LOA -3.9 to 2.4kg). The ICCs were 0.95 and 0.97, respectively. CONCLUSIONS Hand-held dynamometry is reliable in measuring elbow flexor and knee extensor strength in people with ILD.
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Affiliation(s)
- Leona Dowman
- Department of Physiotherapy, La Trobe University/Alfred Health Clinical School, Alfred Centre, Prahran, VIC 3181, Australia; Department of Physiotherapy, Austin Health, Heidelberg VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Christine F McDonald
- Department of Respiratory & Sleep Medicine, Austin Health, Heidelberg, VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Catherine J Hill
- Department of Physiotherapy, Austin Health, Heidelberg VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Annemarie Lee
- Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia; Department of Physiotherapy, Alfred Health, Prahran, VIC 3181, Australia.
| | - Kathryn Barker
- Department of Physiotherapy, Western Health, Footscray, VIC 3011, Australia.
| | - Claire Boote
- Department of Physiotherapy, Western Health, Footscray, VIC 3011, Australia.
| | - Ian Glaspole
- Allergy, Immunology & Respiratory Medicine Department, Alfred Health, Prahran, VIC 3181, Australia.
| | - Nicole Goh
- Department of Respiratory & Sleep Medicine, Austin Health, Heidelberg, VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia; Allergy, Immunology & Respiratory Medicine Department, Alfred Health, Prahran, VIC 3181, Australia.
| | - Annemarie Southcott
- Department of Respiratory & Sleep Disorders Medicine, Western Health, Footscray, VIC 3011, Australia.
| | - Angela Burge
- Department of Physiotherapy, Alfred Health, Prahran, VIC 3181, Australia.
| | - Rebecca Ndongo
- Department of Physiotherapy, La Trobe University/Alfred Health Clinical School, Alfred Centre, Prahran, VIC 3181, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Alicia Martin
- Department of Physiotherapy, Western Health, Footscray, VIC 3011, Australia.
| | - Anne E Holland
- Department of Physiotherapy, La Trobe University/Alfred Health Clinical School, Alfred Centre, Prahran, VIC 3181, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia; Department of Physiotherapy, Alfred Health, Prahran, VIC 3181, Australia.
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Dowman L, McDonald CF, Hill C, Lee A, Barker K, Boote C, Glaspole I, Goh N, Southcott A, Burge A, Ndongo R, Martin A, Holland AE. The benefits of exercise training in interstitial lung disease: protocol for a multicentre randomised controlled trial. BMC Pulm Med 2013; 13:8. [PMID: 23369075 PMCID: PMC3564686 DOI: 10.1186/1471-2466-13-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 11/10/2022] Open
Abstract
Background Interstitial lung disease encompasses a diverse group of chronic lung conditions characterised by distressing dyspnoea, fatigue, reduced exercise tolerance and poor health-related quality of life. Exercise training is one of the few treatments to induce positive changes in exercise tolerance and symptoms, however there is marked variability in response. The aetiology and severity of interstitial lung disease may influence the response to treatment. The aims of this project are to establish the impact of exercise training across the range of disease severity and to identify whether there is an optimal time for patients with interstitial lung disease to receive exercise training. Methods/Design One hundred and sixteen participants with interstitial lung disease recruited from three tertiary institutions will be randomised to either an exercise training group (supervised exercise training twice weekly for eight weeks) or a usual care group (weekly telephone support). The 6-minute walk distance, peripheral muscle strength, health-related quality of life, dyspnoea, anxiety and depression will be measured by a blinded assessor at baseline, immediately following the intervention and at six months following the intervention. The primary outcome will be change in 6-minute walk distance following the intervention, with planned subgroup analyses for participants with idiopathic pulmonary fibrosis, dust-related interstitial lung disease and connective-tissue related interstitial lung disease. The effects of disease severity on outcomes will be evaluated using important markers of disease severity and survival, such as forced vital capacity, carbon monoxide transfer factor and pulmonary hypertension. Discussion This trial will provide certainty regarding the role of exercise training in interstitial lung disease and will identify at what time point within the disease process this treatment is most effective. The results from this study will inform and optimise the clinical management of people with interstitial lung disease. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611000416998
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Affiliation(s)
- Leona Dowman
- Department of Physiotherapy, Austin Health, Melbourne, Australia.
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Shotton MW, Pope LH, Forsyth VT, Denny RC, Archer J, Langan P, Ye H, Boote C. New Developments in Instrumentation for X-ray and Neutron Fibre Diffraction Experiments. J Appl Crystallogr 1998. [DOI: 10.1107/s0021889898005287] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
New instrumentation has been developed for use in X-ray and neutron fibre diffraction studies to provide automated control of sample position, orientation and ambient relative humidity. A sample mount system has been constructed for the Keele fibre diffraction camera on beamline 7.2 at the Daresbury Laboratory synchrotron radiation source. This allows the sample position and orientation to be controlled remotely, without disturbing the sample environment or the detector, and permits the implementation of efficient data-collection strategies. The system can be used to record entire datasets without incurring any loss of data in the meridional region of the diffraction pattern and has also been used to record three-dimensional datasets from fibres exhibiting `double orientation'. The design incorporates a translation feature so that the effects of radiation damage during data collection can be minimized. An automated humidity control system has also been constructed and can be used in either X-ray or neutron fibre diffraction studies where the water content of samples is a critical parameter and careful control of the relative humidity of the sample environment is required. This system allows the relative humidity to be controlled according to a pre-programmed set of instructions and alleviates some of the common problems that are encountered with conventional methods that require the use of saturated salt solutions. The system is currently installed on instrument D19 at the Institut Laue–Langevin, Grenoble. Results illustrating the application of these facilities in high-angle fibre diffraction studies of DNA are presented.
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