Virtual reality for COPD exacerbation: A randomized controlled trial.

BACKGROUND: Pulmonary rehabilitation (PR) is an effective treatment method for chronic obstructive pulmonary disease (COPD). However, individuals with chronic diseases that require lifelong treatment and experience exacerbations need motivational methods. OBJECTIVES: The aim of this study was to examine the effects of virtual reality on symptoms, daily living activity, functional capacity, anxiety and depression levels in COPD exacerbation. METHODS: Fifty patients hospitalized for COPD exacerbation were included in the study. They were randomly assigned to two groups. Twenty-five patients participated in a traditional PR (once-daily until discharge), including pedaling exercises. The second/25 patients followed the same protocol but experienced cycling simulation in the forest via virtual reality (VR + PR). All patients were evaluated using 1-minute/Sit-to-Stand test (STST), modified-Medical Research Council (mMRC) scale, COPD Assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), and London Chest Activities of Daily Living (LCADL) before and after the treatment. RESULTS: The STST showed an increase in both groups post-treatment, notably higher in the VR + PR (p = 0.037). Dyspnea levels and CAT scores decreased in all patients, but the decrease was greater in the PR + VR group for both parameters (p = 0.062, p = 0.003; respectively). Both groups experienced a reduction in the HADS scores compared to the pre-treatment, with a more significant decrease in depression and the total score in the VR + PR (p < 0.05). LCADL's sub-parameters and total score, excluding household, decreased in both groups after treatment (p < 0.05). The improvement was more substantial in the VR + PR. CONCLUSIONS: Virtual reality provides benefits in the management of COPD exacerbations and can be used safely. CLINICAL TRIAL REGISTIRATION: Registered at clinicaltrials.gov, registration ID: NCT05687396, URL: www. CLINICALTRIALS: gov.

The effects of face masks on cardiopulmonary capacity in healthy young individuals.

BACKGROUND: Due to the SARS-CoV-2 pandemic that affected the world in a short time, face masks were recommended by all authorities and started to be used widely. Few studies have reported the effects of face masks on cardiopulmonary capacity. In this critical period, there is a need to contribute to the literature to clarify the effects of face masks. The aim of the study was to examine the effect of face masks on cardiopulmonary capacity. METHODS: In this prospective cross-over study, the effect of wearing nomask (nm), surgical mask (cm) and FFP2/N95 (ffpm) mask was examined in 16 healthy individuals (age: 23.12±1.4, BMI: 22.91±12.8, 8 women). Forty-eight tests were performed randomly with the standard cycle ergometer. Time to exhaustion, maximum power, heart rate, dyspnea, respiratory frequency and oxygen saturation were evaluated. Ten domains of the comfort/discomfort levels of wearing mask were evaluated by questionnaire. RESULTS: Time to exhaustion were 383±118, 348.25±106 and 338.62±97 seconds (nm, cm and ffpm, respectively; P<0.001). The maximum power was 125±31.62 Watt in all measurements. There was no significant differences in physiological parameters except dyspnea (P=0.004). A significant difference was found between the masks in terms of tightness and breathing resistance in terms of mask comfort/discomfort (P=0.001, P=0.02, respectively). CONCLUSIONS: Cardiopulmonary exercise capacity was reduced in healthy young individuals due to surgical mask and ffpm/N95. In addition to this effect, breathing resistance and tightness should be considered in face masks recommendations during exercise.

The sub-acute effects of high-intensity interval training in healthy young adults: respiratory parameters, aerobic capacity and perceived stress.

BACKGROUND: Although the effects of sub-maximal continuous aerobic training (SCT) and high-intensity interval training (HIIT) are well studied in performance athletes and in several patient groups, there is not much evidence about the effects of these exercises in sedentary healthy young population. The aim of the study was to compare the effects of these two different types of aerobic exercises on respiratory parameters, aerobic capacity and perceived stress in healthy university students. METHODS: Thirty-six healthy, young subjects with a mean age of 20.83±0.97 years were included in the study (N.=19 in HIIT and N.=17 in SCT). Pulmonary function tests (PFTs) and respiratory muscle strength (RMS) assessments were done using a desktop spirometer. Aerobic capacity was estimated with the Bruce treadmill exercise test. The Perceived Stress Scale (PSS) was used for the assessment of stress perception. All participants exercised 3 times per week for 4 weeks (a total of 12 sessions). RESULTS: After 12 sessions, the peak expiratory flow parameter (a PFT value) of both groups showed significant increases, but there was no difference between the groups. The RMS of the subjects increased significantly in both the groups (P<0.05), but there was no significant difference between the groups. Both groups showed significant increases in terms of aerobic capacity (P>0.05), and the improvement was significantly higher in the HIIT group. Perceived stress values showed a significant increase in the SCT group. CONCLUSIONS: Based on the results of this study, the two exercise types were found to have similar effects on RMS. Also, when compared with SCT, HIIT was found to have more effect on aerobic capacity.

Investigation of the effectiveness of aerobic exercise training in individuals with ankylosing spondylitis: Randomized controlled study.

OBJECTIVE: To investigate the effect of the addition of aerobic training to spinal mobility exercises on disease-specific outcomes and functional exercise capacity, aerobic capacity and respiratory muscle strength of ankylosing spondylitis (AS) patients. METHODS: The study included 31 volunteers (mean age: 44.90 ± 11.52 years) diagnosed with AS. The demographic characteristics and disease-related data of all subjects were recorded, then, the Bath AS Disease Activity Index (BASDAI), Bath AS Metrology Index (BASMI) and Bath AS Disease Function Index (BASFI), the 6-minute walk test, the Bruce Treadmill Test and spirometry were used, respectively. The intervention group attended a 12-week program of aerobic exercise sessions, plus supervised spinal mobility exercises, 3 days a week. The control group performed the supervised spinal mobility exercises only, 3 times a week, for 12 weeks. RESULTS: There was a significant improvement in BASDAI (p = .002), BASMI (p = .021), 6 DYT (p = .036), VO2 max (p = .000), MIP (p = .005) and MEP (p = .022) results in the intervention group after 12 weeks of training. In the comparisons of the pre-treatment and post-treatment differences, BASDAI (p = .032) decreased and VO2 (p = .001) max increased, showing significant improvements in the intervention group and these values were maintained. CONCLUSION: It is striking that improvements in all parameters except BASFI were achieved in the aerobic training group. These results demonstrate that an aerobic exercise program should be included in an individual exercise prescription for the management of AS.

The effects of type 2 diabetes mellitus and its complications on physical and pulmonary functions: A case-control study.

AIMS: This study was planned to determine the effects of type 2 diabetes mellitus (DM) and its complications on physical and pulmonary functions. Methods: A total of 110 individuals aged 40-65 years were included in the study, 58 with type 2 DM (study group) and 52 without DM (control group). Physical activity level, functional capacity, pulmonary function, and comorbidity levels were compared between the groups. Results: The mean age of the individuals was 52.42 ± 5.88 years. Six-minute walk test distance was 507.2 ± 51.70 m in the study group and 532.23 ± 50.32 m in the control group (p < 0.05, Cohen's d = 0.49). The pulmonary function test results of the study and control groups were determined as forced vital capacity (FVC) (%): 99.17 ± 14.13 and 104.65 ± 16.01 (p > 0.05), forced expiratory volume in one second (FEV1) (%): 96.78 ± 14.43 and 99.73 ± 15.80 (p > 0.05), and FEV1/FVC ratio: 81.97 ± 4.62 and 80.16 ± 5.27 (p > 0.05), respectively. The Charlson Comorbidity Index scores of the study and control groups were 1.83 ± 0.82 and 0.12 ± 0.32 (p < 0.05). Conclusions: Type 2 DM was associated with lower functional capacity and higher rates of comorbid diseases. Therefore, potential causes of these parameters should be considered in the rehabilitation of type 2 diabetic patients.

Postoperative respiratory muscle training in addition to chest physiotherapy after pulmonary resection: A randomized controlled study.

Purpose: The effects of preoperative respiratory muscle training (RMT) on postoperative complications in patients with pulmonary resection have recently attracted the attention of researchers. More studies are obviously needed to clarify the effects of RMT after pulmonary resection. The aim of this study was to evaluate the effectiveness of intense RMT in addition to chest physiotherapy after pulmonary resection in terms of respiratory muscle strength, exercise capacity, and length of hospital stay rather than postoperative complications. Methods: Forty subjects undergoing pulmonary resection were included in the study. Subjects were divided into two groups using a simple randomization method. The subjects in the study group (SG; n = 20) received RMT in addition to regular chest physiotherapy in the postoperative period. The subjects in the control group (CG; n = 20) received only regular chest physiotherapy. Respiratory muscle strength (maximal inspiratory and expiratory pressure [PImax and PEmax]) was measured pre-postoperatively and before discharge, and exercise capacity, which was measured by the 6-min walk test (6MWT), was assessed preoperatively and before discharge. The length of hospital stay was also recorded. Results: There were no differences between groups in terms of demographic and surgical characteristics. The nonsignificant change of PImax from the preoperative to the discharge value was 65.1 ± 15.5 to 68.2 ± 19.2 cmH2O in SG and 59.2 ± 13.7 to 44.3 ± 14.8 cmH2O in CG (p > 0.05, p > 0.05, respectively). The change of PEmax from the preoperative to the discharge value was 80.4 ± 24.9 to 81.5 ± 24.9 cmH2O in SG (nonsignificant) and 85.4 ± 38.2 to 61.3 ± 25.4 cmH2O in CG (p > 0.05, p = 0.002, respectively). There was a significant difference between SG and CG in terms of RMT effect (PImax: 11.05 [21.84; 0.25] cmH2O p = 0.045; PEmax: 25.23 [42.83; 7.62] cmH2O p = 0.006). A significant difference was found in the 6MWT when the mean differences were compared between the groups (85.72 [166.15; 5.28] m p = 0.037). The length of hospital stay was significantly shorter in the SG (number of days for SG 9.1 ± 3 and for CG 12.9 ± 4.2 [p = 0.002]). Conclusion: The addition of RMT to chest physiotherapy after pulmonary resection can have positive effects on respiratory muscle strength, exercise capacity, and length of hospital stay.

The efficiency of inspiratory muscle training in patients with ankylosing spondylitis.

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease affecting mainly the axial skeleton and sacroiliac joints. The aim of the current study was to investigate the effects of inspiratory muscle training (IMT) on respiratory muscles and functional exercise capacity, as well as on the specific outcomes of the disease in AS patients. A total of 32 AS patients (mean age 37.37 ± 10.41 years) were randomly assigned as the Training Group (TG) (n = 16, mean age = 35.62 ± 8.18 years) who received IMT + conventional exercise, and the Control Group (CG) (n = 16, mean age = 39.12 ± 12.26 years) who only performed the conventional exercise program. All the subjects were evaluated at baseline and at the end of the 8th week. Respiratory muscle strength was assessed by measuring the maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax). Functional exercise capacity was measured using the 6-min walk test (6MWT). The Bath AS Disease Activity Index (BASDAI), Bath AS Disease Function Index and Bath AS Metrology Index were used for activity, function and basic measurements of the disease. A statistically significant improvement was determined in the PImax (p = 0.000), PEmax (p = 0.002), 6MWT (p = 0.041) and BASDAI (p = 0.049) values in the TG after training. There was a significant difference between baseline and after conventional exercise in terms of PEmax (p = 0.017) in the CG. The PEmax (p = 0.001) and the 6MWT (p = 0.053) values were significantly better in the TG. The results of this study demonstrated that IMT in addition to conventional exercises increased inspiratory muscle strength, functional exercise capacity and positively affected the disease activity in AS.

Quality of life, depression and musculoskeletal pain experience among employed women: A controlled study.

OBJECTIVE: The musculoskeletal pain is one of the leading health problems among employed women. The aim of our study was to examine musculoskeletal pain, depression and quality of life (QOL) among employed women and find out the differences with unemployed women. METHODS: A hundred and fifty employed women and 151 housewives were included in our study. We used visual analog scale (VAS) for the assessment of pain, Beck Depression Inventory (BDI) for the depressive symptoms and Nottingham Health Profile (NHP) for the assessment of QOL. RESULTS: The ratio of musculoskeletal pain among employed women and unemployed women were found as 42.5% and 57.5% respectively. A mild level of depression was found among employed women whereas moderate and vigorous level of depression were found among unemployed women. There were significant differences in terms of depression and QOL parameters. When the correlations of pain, depression and QOL were analyzed, significant high positive relationships between spinal, lower extremity, upper extremity pain levels and BDI and NHP were found only in housewives. CONCLUSIONS: Lower levels of depression among employed women can give the idea that social ambience at work place, focusing at work and economic independence play a role in decreasing depression.