Sarcopenia in patients with malignant pleural effusion: impact on symptoms, health status, and response to hospitalization.

BACKGROUND: Malignant pleural effusion (MPE) refers to the presence of neoplastic cells in the pleural fluid and was previously associated with lung cancer, breast cancer, and lymphoma. Patients with MPE effusion have significant symptoms, diminishing their overall quality of life but little is known about the influence sarcopenia may have on their clinical presentation. PURPOSE: To examine the prevalence of sarcopenia in patients with MPE and its relationship with symptoms, health status, and the response to hospitalization. METHODS: Seventy-four patients with MPE underwent measurements of symptoms, health-related quality of life, and functional status upon admission, discharge, and 3 months after hospital discharge. RESULTS: Patients with MPE and sarcopenia were symptomatic during hospitalization and at discharge. Additionally, health-related quality of life and functional status were worse in patients with MPE and sarcopenia. All measures of patients with MPE and sarcopenia were significantly poorer 3 months after hospital discharge. CONCLUSIONS: Sarcopenia is a clinical characteristic with substantial negative effects in patients with MPE. Specific interventions may need to be provided, designed, and offered in the clinical setting.

Repercussions of plagiocephaly on posture, muscle flexibility and balance in children aged 3-5 years old.

AIM: The objective of the study was to assess posture, muscle flexibility and balance in children aged 3-5 years old with a history of nonsynostotic plagiocephaly. METHODS: Fifty-two children with previous history of plagiocephaly were evaluated, along with 52 control subjects matched for age, sex, height, weight and physical activity. The outcome measures included static posture, assessed through the measurement of angles and distances between anatomical landmarks; muscle flexibility, evaluated with the Stibor, Shober and finger-to-floor distance tests and balance, assessed by the Pediatric Balance Scale. RESULTS: One-way analysis of variance afforded statistically significant differences (P < 0.05) in head position, muscle flexibility (thoracic mobility and trunk and lower limbs muscle shortening) and balance. CONCLUSION: Children with previous history of non-synostotic plagiocephaly present changes in head position, muscle shortening and a poor balance when compared to control children at 3-5 years old.

Acute Effects of Contract-Relax Stretching vs. TENS in Young Subjects With Anterior Knee Pain: A Randomized Controlled Trial.

Valenza, MC, Torres-Sánchez, I, Cabrera-Martos, I, Valenza-Demet, G, and Cano-Cappellacci, M. Acute effects of contract-relax stretching vs. TENS in young subjects with anterior knee pain: A randomized controlled trial. J Strength Cond Res 30(8): 2271-2278, 2016-The aim of this study was to examine the immediate effects on pressure point tenderness, range of motion (ROM), and vertical jump (VJ) of contract-relax stretching vs. transcutaneous electrical nerve stimulation (TENS) therapy in individuals with anterior knee pain (AKP). Eighty-four subjects with AKP were randomly assigned to 1 of 3 different intervention groups: a contract-relax stretching group (n = 28), a TENS intervention group (n = 28), and a control group (n = 28). The participants included in the sample were both sex (37.5% men vs. 62.5% women) at a mean age of 21 years, with mean values of height and weight of 169 cm and 64 kg, respectively. The main outcome measures were knee ROM, pressure pain threshold (PPT), and VJ. The participants were assessed at baseline and immediately after treatment. In the case of VJ, at baseline, immediately after the intervention, at 3 and at 6 minutes posttreatment. The data analysis showed that PPT scores of participants in the stretching and TENS group significantly increased from pretest to posttest (p ≤ 0.05). A significant increase pre- to posttreatment in ROM (p < 0.001) was also observed in both treatment groups. In VJ measures, TENS and stretching groups showed significant differences between preintervention and all postintervention values (p ≤ 0.05), whereas no significant differences were found in the control group. In conclusion, the results show significant pre-to-post-treatment effects in PPT, ROM, and VJ from both contract-relax stretching and TENS in young subjects with AKP.

Impact of torticollis associated with plagiocephaly on infants' motor development.

OBJECTIVE: This study investigated whether torticollis (congenital or acquired) in infants with plagiocephaly affects the achievement of specific gross motor milestones. METHODS: A total of 175 infants affected by plagiocephaly with or without torticollis were recruited and included in this prospective trial. Anthropometric and clinical variables were recorded at baseline. The infants were included in a physiotherapy treatment program, and they were monthly assessed until hospital discharge. RESULTS: Significant differences (P < 0.05) were observed in the achievement of rolling over, crawling, and standing skills depending on the specific profile (plagiocephaly and plagiocephaly with congenital or acquired torticollis). After adjusting for the severity of the plagiocephaly and the age at referral, the torticollis was significantly (P < 0.05) associated with crawling and standing skills. CONCLUSIONS: The findings suggest that the presence or absence of congenital or acquired torticollis is an important factor that affects gross motor development in infants with plagiocephaly.

The Effects of Doming of the Diaphragm in Subjects With Short-Hamstring Syndrome: A Randomized Controlled Trial.

CONTEXT: Taking into account the complex structure of the diaphragm and its important role in the postural chain, the authors were prompted to check the effects of a diaphragm technique on hamstring flexibility. OBJECTIVE: To evaluate the effects of the doming-of-the-diaphragm (DD) technique on hamstrings flexibility and spine mobility. DESIGN: Randomized placebo-controlled trial. SETTING: University laboratory. PATIENTS: Sixty young adults with short-hamstring syndrome were included in this randomized clinical trial using a between-groups design. INTERVENTION: The sample was randomly allocated to a placebo group (n = 30) or an intervention group (n = 30). Duration, position, and therapist were the same for both treatments. MAIN OUTCOME MEASURES: Hamstring flexibility was assessed using the forward-flexion-distance (FFD) and popliteal-angle test (PAT). Spinal motion was evaluated using the modified Schober test and cervical range of movement. RESULTS: Two-way ANOVA afforded pre- to postintervention statistically significant differences (P < .001) in the intervention group compared with the placebo group for hamstring flexibility measured by the FFD (mean change 4.59 ± 5.66 intervention group vs 0.71 ± 2.41 placebo group) and the PAT (mean change intervention group 6.81 ± 8.52 vs placebo group 0.57 ± 4.41). Significant differences (P < .05) were also found in the modified Schober test (mean change intervention group -1.34 ± 3.95 vs placebo group 1.02 ± 3.05) and cervical range of movement. Significant between-groups differences (P < .05) were also found in all the variables measured. CONCLUSIONS: The DD technique provides sustained improvement in hamstring flexibility and spine mobility.

Effectiveness of an occupational therapy intervention in reducing emotional distress in informal caregivers of hip fracture patients: a randomized controlled trial.

OBJECTIVE: To examine the effectiveness of an occupational therapy intervention program in reducing emotional distress in informal caregivers of hip fracture patients. DESIGN: Single-blind randomized controlled trial. SETTING: A public Trauma and Rehabilitation Hospital in Granada, Spain. PARTICIPANTS: A total of 186 caregivers and their care recipients with hip fracture (93 in each group) were allocated to an intervention group or a control group using a block system. INTERVENTION: An occupational therapy intervention during patient hospitalization focused on patient handling by caregivers and ergonomic treatment for both. MAIN MEASURES: The Goldberg General Health Questionnaire was used to measure emotional distress and psychological well-being. The Goldberg Anxiety and Depression Scale was used to measure caregiver affective illness. RESULTS: Among informal caregivers, emotional distress decreased to a greater extent in the intervention group than in the control group from the first assessment to the six-month follow-up (intervention group: 4.16 (SD 4.57) to 2.81 (SD 2.93); control group: 4.61 (SD 4.57) to 4.24 (SD 4.30)), showing significant differences at the first, third and sixth month. As regards anxiety levels, significant differences were only found at the third month (1.54 (SD 2.09) vs. 2.35 (SD 2.53) in the intervention and control groups, respectively (p < 0.05)), although the intervention group always showed lower levels from the first month. Although depression levels decreased in both groups, the decrease was also greater in the intervention group. CONCLUSION: Occupational therapy training for caregivers of hip fracture patients helps to significantly reduce emotional distress, anxiety and depression in caregivers.

Effect of occupational therapy on functional and emotional outcomes after hip fracture treatment: a randomized controlled trial.

OBJECTIVE: To explore whether an occupational therapy intervention combined with physiotherapy rehabilitation improved hip fracture patient outcomes regarding emotional distress, fatigue, independence and function. DESIGN: Randomized controlled trial. SETTING: Inpatient trauma ward in a rehabilitation and trauma hospital. PARTICIPANTS: One hundred and twenty-two patients admitted into hospital for hip fracture. INTERVENTION: Patients were randomly assigned to a standard care group (SC, n = 61) or a combined treatment group (CT, n = 61). The SC group received conventional hospital care for hip fracture patients and the CT group underwent occupational therapy as well. MAIN MEASURES: Patients' emotional distress (GHQ-28), perceived fatigue (the first item of the BASDAI using a 0-100 visual analogue scale scale), level of independence (Modified Barthel Index) and function (Harris Hip Score) were measured at baseline and one, three and six months after the intervention. RESULTS: Patients in the CT group experienced a considerable decrease of emotional distress at three and six months (p = 0.005 and p < 0.001, respectively). A between-group analysis showed significant differences in emotional distress at one, three and six months (p < 0.001). Although fatigue levels decreased in the SC group, the most significant decline was reported by the CT group at six months (p < 0.001, mean difference = 14 points). Regarding independence level, significant differences were found within groups at each stage, but also between groups at one month in favor of the CT group. Function improved in both groups compared with baseline (p < 0.001), but no significant differences were found in functionality between groups. CONCLUSION: Although both groups reported significant improvements, patients in the CT group had better scores in emotional distress and dependence throughout follow-up and better scores in all measures at six months.

Results on health-related quality of life and functionality of a patient-centered self-management program in hospitalized COPD: a randomized control trial.

Objective: The main objective of this study was to evaluate the results of an in-hospital Self-Management program in addition to physiotherapy in severe patients with Chronic Obstructive Pulmonary Disease (COPD) compared to a physiotherapy program.Methods: In this randomized clinical trial, 66 acute exacerbation COPD patients were included and were randomly divided into three groups. The Control group received standard medical treatment. The Physical therapy group received Control Group intervention plus a Physical Therapy intervention, consisting of neuromuscular stimulation therapy on the quadriceps muscle accompanied by lower limb exercises. The Self-management group received Physical Therapy group intervention plus a Self-Management program, which included educational information complemented with a problem-based session, breathing exercises and relaxation exercises. The main outcomes measured were the health-related quality of life and functionality.Results: All treated groups show improvements in all outcomes, being significant in the case of all total scores of health-related quality of life and functionality(p < 0.05) between Physical Therapy group and Self-Management group. At 3 months, health-related quality of life shows reductions in all subscores in Control Group and Physical Therapy groups, while Self-Management group shows minimal maintenance of the values.Conclusion: An individualized Self-Management program added to a physiotherapy program administered once a day improves health-related quality of life and functionality compared to a Physical Therapy and to a Control Group in hospitalized severe COPD patients.Implications for rehabilitationSelf-management is the most challenging area of chronic diseases improving patient self- efficacy and reducing cost.A self-management program improves health-related quality of life and functionality compared to a physical therapy treatment in severe Chronic Obstructive Pulmonary Disease hospitalized patients.

Changes in neck mobility and pressure pain threshold levels following a cervical myofascial induction technique in pain-free healthy subjects.

OBJECTIVE: The purpose of this study was to investigate if the application of a cervical myofascial induction technique targeted to the ligamentum nuchae resulted in changes in cervical range of motion and pressure pain thresholds (PPT) in asymptomatic subjects. METHODS: Thirty-five subjects, 8 men and 27 women (mean age, 21 +/- 4 years), without a current history of neck, shoulder, or arm pain participated. Participants were randomly divided into 2 groups: the experimental group, which received a real cervical myofascial induction technique, and the control group, which received a sham-manual procedure. Bilateral PPT levels over C5-C6 zygapophyseal joints and tibialis anterior muscles and neck mobility were assessed preintervention and 5 minutes postintervention by an assessor blinded to the treatment allocation of the subject. Separate mixed-model analyses of variance were used to examined the effects of the treatment on neck mobility and PPT levels as the dependent variable, with group (experimental or control) as the between-subjects variable and time (pre-post test) or side (dominant, nondominant) as the within-subjects variable. The hypothesis of interest was the group x time interaction at an a priori alpha level equal to .05. RESULTS: The group x time interaction was statistically significant for cervical flexion (F = 5.4; P = .03), extension (F = 3.3; P = .045), and left lateral-flexion (F = 4.6; P = .04), but not for right lateral-flexion (F = 2.5; P = .1), right rotation (F = 0.5; P = .5), and left rotation (F = 0.09; P = .2). Subjects receiving the real cervical myofascial induction technique experienced greater improvement in cervical mobility when compared with the control group. The group x time interaction did not reveal any significance for PPT in the C5-C6 zygapophyseal joints (F = 0.5; P = .5) and in the tibialis anterior muscle (F = 0.2; P = .8). CONCLUSIONS: The application of a cervical myofascial induction technique resulted in an increase in cervical flexion, extension, and left lateral-flexion, but not rotation motion in a cohort of healthy subjects. No changes in PPT in either C5-C6 zygapophyseal joint (local point) or tibialis anterior muscle (distant point) were found.

Effects of home-based neuromuscular electrical stimulation in severe chronic obstructive pulmonary disease patients: a randomized controlled clinical trial.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients experience a sustained deterioration of several capacities. Those with severe COPD undergo a considerable decline in their physical and functional capacities, but pulmonary rehabilitation (PR) is used to reduce the weakness of such patients. To date, neuromuscular electrical stimulation (NMES) has been used in acute COPD patients but NMES superimposed onto voluntary muscular contraction has not been tested in COPD patients. AIM: The aim of this study was to evaluate the effects of superimposed NMES on the cardiorespiratory performance and functionality of severe COPD patients undergoing a home-based rehabilitation program. DESIGN: This was a randomized controlled clinical trial. POPULATION: A total of 36 stable severe COPD patients were included in this study and were randomly divided into two groups: an intervention group and a control group. SETTING: The study was conducted as a home-based program. METHODS: The control group received standard medical treatment. The intervention group additionally underwent an individualized physical therapy program. The intervention consisted of a pulmonary rehabilitation (PR) protocol for 8 weeks (2 h/week). The protocol was carried out as follows: 10 minutes of controlled breathing training; 30 minutes of NMES superimposed onto voluntary muscular contraction; and 5 minutes of relaxation/cool-down. The outcome measures were cardiorespiratory performance measured using the 6-Minute Walk Test in the treadmill and functionality assessed with the functional independence measure. RESULTS: In the intervention group, significant improvements were observed after the treatment in cardiorespiratory performance and functionality (P<0.05), while the control group did not show any significant changes (P>0.05). The between-group analysis showed significant differences in cardiorespiratory performance and functionality (P<0.05). CONCLUSIONS: An 8-week individualized home-based PR program including controlled breathing training, aerobic exercise with elastic bands, and NMES superimposed onto voluntary muscle contraction significantly improves cardiorespiratory performance and functionality in stable COPD patients. CLINICAL REHABILITATION IMPACT: A home-based pulmonary rehabilitation program including controlled breathing training, and NMES superimposed onto voluntary muscle contraction significantly improves cardiorespiratory performance and functionality in stable COPD patients.

Physical and Functional Impairment During and After Hospitalization in Subjects With Severe COPD Exacerbation.

BACKGROUND: COPD exacerbations are frequent events that have a negative impact on the lives of patients. The aims of this study were to analyze physical and functional impairment during hospital stay in subjects hospitalized due to COPD exacerbation and to assess the physical and functional impact of hospitalization at a 1-month follow-up in patients with severe COPD. METHODS: This was a prospective observational study on a sample of 52 subjects hospitalized due to COPD exacerbation. The assessments were performed at baseline, discharge, and 1-month follow-up. The outcome measures were dyspnea, muscle strength, functional capacity, and postural steadiness. RESULTS: Quadriceps strength [1.036 (P = .043) kg mean difference] and the one-leg stance test [1.04 (P = .02) and 0.73 (P = .032) s mean difference right and left leg] showed significant impairment during hospitalization. Dyspnea perception improved significantly (P = .004) during hospitalization. Additionally, strength in the upper and lower limbs [4.04 (P = .002) and 1.23 (P = .038) kg mean difference], functional capacity [3.0 number of steps mean difference (P = .032)], and the one-leg stance test [2.12 (P = .006) and 0.53 (P = .047) s mean difference right and left leg] showed significant impairment 1-month follow-up. CONCLUSIONS: Hospitalization due to COPD exacerbation leads to physical and functional impairment in patients; impairment is greater at 1-month follow-up. It would be interesting to conduct physical therapy interventions to prevent the impairment.

Effects of a dance-based aquatic exercise program in obese postmenopausal women with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To evaluate the effects of a dance-based aquatic exercise program on functionality, cardiorespiratory capacity, postexercise heart rate, and fatigue in obese postmenopausal women with knee osteoarthritis. METHODS: A randomized controlled trial was performed. In all, 34 obese women diagnosed with knee osteoarthritis participated. Women were randomly allocated to an experimental group (n = 17) or a control group (n = 17). Participants in the experimental group were included in an 8-week dance-based aquatic exercise program conducted in community swimming pools. Those in the control group underwent a global aquatic exercise program. The primary outcome measure was functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were cardiorespiratory capacity evaluated with the 6-minute walk test, and postexercise heart rate and fatigue assessed using a visual analog scale. Variables were measured at baseline, after the intervention, and at 3-month follow-up. RESULTS: A between-group analysis showed significant postintervention differences in functionality (aggregate postintervention WOMAC score of 37.30 ±â€Š16.61 vs 41.83 ±â€Š13.69; P = 0.048) in favor of the experimental group. In addition, significant between-group differences were found after the 8 weeks in cardiorespiratory capacity, postexercise heart rate, and fatigue. Follow-up continued to show significant differences between groups in function (aggregate WOMAC score of 38.60 ±â€Š13.61 vs 42.60 ±â€Š9.05; P = 0.038), postexercise heart rate, and fatigue. CONCLUSIONS: An 8-week dance-based exercise program significantly improved function and cardiorespiratory capacity, and decreased postexercise heart rate and fatigue. Most of these improvements were maintained at 3-month follow-up in obese postmenopausal women.

Effectiveness of a flamenco and sevillanas program to enhance mobility, balance, physical activity, blood pressure, body mass, and quality of life in postmenopausal women living in the community in Spain: a randomized clinical trial.

OBJECTIVE: This study aimed to test the effectiveness of a dance therapy program in improving mobility, balance, physical activity, blood pressure (BP), body mass, and quality of life in postmenopausal women in Spain. METHODS: Fifty-two sedentary postmenopausal women (mean age 69.27 ±â€Š3.85 y) were randomly assigned to receive either dance therapy (n = 27) or self-care treatment advice (n = 25). The intervention group participated in 2 months of dance therapy, three sessions weekly, based on Spanish folk dance (flamenco and sevillanas). The control group was provided a booklet containing physical activity recommendations. Mobility, balance, physical activity, BP, body mass, and quality of life were assessed at baseline and posttreatment in both groups. Statistical analysis was performed using a 2 × 2 analysis of variance (ANOVA). RESULTS: Women in the intervention group showed significant improvements in mobility and balance (timed up-and-go test [P = 0.022], cognitive timed up-and-go [P = 0.029], and one-leg stance test results [P = 0.001]), physical activity (total time index [P = 0.045], energy expenditure [P = 0.007], vigorous physical activity [P = 0.001], leisure activity [P = 0.001], moving [P < 0.001], and activity dimension summary [P = 0.001]), and fitness (overall fitness [P = 0.039], cardiorespiratory fitness [P < 0.001], speed-agility [P = 0.001], and flexibility [P = 0.007]) compared with those in the control group. No differences were observed in BP, body mass, or quality of life. CONCLUSIONS: Spanish dance therapy may be effective to improve mobility, balance, and levels of physical activity and fitness in sedentary postmenopausal women.

[Effects of a dance therapy programme on quality of life, sleep and blood pressure in middle-aged women: A randomised controlled trial]. / Efectos de un programa de terapia de baile en la calidad de vida, el sueño y la presión arterial en mujeres de mediana edad: un ensayo controlado aleatorizado.

BACKGROUND AND OBJECTIVE: Evidence suggests that dance therapy may have positive effects in areas such as cardiovascular parameters and sleep. The aim of the present study is to explore whether a dance therapy programme improves sleep and blood pressure in a population of middle-aged pre-hypertensive and hypertensive women. METHODS: A randomised controlled trial was conducted, in which participants were assigned to one of 2 groups: standard care (with usual activities and medication) or dance therapy (in which the participants followed a dance therapy programme, in addition to their medication). The intervention was an 8-week, 3-times-per-week, progressive and specific group dance-training programme. The dance steps were specifically designed to improve balance by shifting the body and relocating the centre of gravity. The main measures obtained were blood pressure, sleep quality and quality of life, measured by the Pittsburgh Sleep Quality Index and the European Quality of Life Questionnaire. RESULTS: Sixty-seven pre-hypertensive and hypertensive middle-aged women were randomised to either an intervention group (n=35) or a control group (n=32) after baseline testing. The intervention group reported a significant improvement in blood pressure values (P<.01), as well as in sleep quality (P<.05) and quality of life (P<.001), compared to the control group. CONCLUSION: The dance therapy programme improved blood pressure, sleep and quality of life in pre-hypertensive and hypertensive middle-aged women, and constitutes an interesting basis for larger-scale research.

Factors Influencing Performance-Oriented Mobility After Hip Fracture.

OBJECTIVE: To identify the patient- and fracture-related determinants that influence performance-oriented mobility in hip fracture patients as measured by the Performance-Oriented Mobility Assessment (POMA) score. METHOD: A prospective study was conducted. Patients aged 65 or older (n = 186) were prospectively recruited. Patients were assessed for mobility (Tinetti POMA), level of independence (Modified Barthel Index), emotional distress (Goldberg General Health Questionnaire), comorbidities (Charlson Comorbidity Index), and Perceived Health (categorical scale). RESULTS: The study revealed that patient age, type of fracture, length of hospital stay, level of emotional distress, and level of independence were significant predictors of performance-oriented mobility. When combined, these factors explained 44.3% of the variance in performance-oriented mobility (r(2) = .443; r(2) adjusted = .414; F = 15.46; p < .001). DISCUSSION: Patients who are older, spend more days in hospital, have worse pre-fracture independence level or higher emotional distress levels at discharge, and sustain subtrochanteric or intertrochanteric fractures seem to have poorer performance-oriented mobility after hip fracture.

Prevalence of risk factors for atrial fibrillation and stroke among 1210 patients with sleep disordered breathing.

AIMS: This study sought to identify the prevalence of risk factors for atrial fibrillation and stroke in a sleep apnea population. METHODS: Study participants included 1210 consecutive adults who were referred with suspicion of sleep apnea. Statistical analysis was used to determine the relationship between sleep apnea syndrome and risk factors for atrial fibrillation and stroke. RESULTS: Among 1210 enrolled patients, 65.8% had severe sleep apnea (Apnea/hypopnea Index--AHI>30), 25.2% had mild to moderate sleep apnea (AHI 5 to 30), and 8.8% had no sleep apnea (AHI<5). At baseline, the mean apnea-hypopnea index in patients with sleep apnea syndrome was 35. Compared to patients with an AHI<5, those with an AHI>30 were older (47.3±11.4 vs. 52.74±12.4, p<0.001) and had a higher body mass index (BMI) (30.7±7.3 vs. 33.83±10.1, p<0.001), a higher prevalence of hypertension (38 vs. 16%, p<0.001), and a higher CHADS2 (congestive heart failure, hypertension, age, diabetes and prior stroke) score (0.59±0.8 vs. 0.28±0.64, p<0.001). CONCLUSIONS: Patients with severe sleep apnea have a higher prevalence of risk factors for atrial fibrillation and stroke when compared with subjects without sleep apnea.

Effectiveness of controlled breathing techniques on anxiety and depression in hospitalized patients with COPD: a randomized clinical Trial.

BACKGROUND: Anxiety and depression are prevalent comorbidities in patients with COPD. Breathing techniques can improve anxiety and depression in patients hospitalized for COPD exacerbation. METHODS: We conducted a randomized clinical study with 46 male subjects, 67-86 years old, hospitalized with acute COPD exacerbation. Subjects were randomly and equally divided into a control group and a controlled breathing intervention group. We measured baseline and post-intervention dyspnea, anxiety and depression, quality of life (with the St George's Respiratory Questionnaire and the European Quality of Life questionnaire), maximum inspiratory and expiratory pressure, hand-grip strength, and sleep quality. The cohort had high dyspnea and low overall quality of life. RESULTS: Controlled breathing techniques significantly improved dyspnea, anxiety, and mobility. All the measured variables improved in the intervention group. The control group had poorer values in all the variables after the hospitalization period. CONCLUSIONS: Controlled breathing exercises improve anxiety and depression in patients hospitalized for COPD exacerbation. (ClinicalTrials.gov NCT01826682).

[Endocrinometabolic disorders in chronic obstructive pulmonary disease]. / Alteraciones endocrinometabólicas en la enfermedad pulmonar obstructiva crónica.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterized by the presence of chronic airflow obstruction and associated endocrinometabolic disorders, which usually worsen the clinic and prognostic of the patients. Therefore, in-depth knowledge of these prevalent disorders in patients with COPD is relevant to develop preventive measures and early detection. PURPOSE: To analyze the prevalence of endocrinometabolic diseases that occur in COPD subjects and their related risk factors. METHODS: We carried out a bibliographic search of the bibliographic resources of the last 10 years, including PubMed, Scopus and ScienceDirect databases. Words used were: "endocrine metabolic disorders AND COPD", "endocrine disorders AND COPD" and "metabolic disorders AND COPD". The bibliographical analysis was made in two steps. During the first phase, we excluded those articles in which the title or their content did not correspond with the objective settled; during the second phase, we deleted all the references duplicated in both databases. Finally, 17 articles after full-text critical appraisal were maintained. RESULTS: After reviewing the articles, we found a significant relationship between diabetes mellitus, metabolic syndrome, obesity, osteoporosis, hypogonadism and COPD. Different authors have reported a higher prevalence of these comorbidities, influencing the development of COPD. CONCLUSIONS: Due to the high prevalence and association with COPD, these comorbidities have to be considered by the health professionals related to the COPD patients. Better understanding of the endocrinometabolic disorders related to COPD can influence the treatment and the outcome of patients.

Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) se caracteriza por obstrucción crónica del flujo aéreo y se asocia frecuentemente a alteraciones endocrino-metabólicas que empeoran la situación clínica del paciente y su pronóstico. El conocimiento en profundidad de estas alteraciones en los pacientes con EPOC permite llevar a cabo medidas preventivas, detección temprana e intervenciones nutricionales adecuadas. Objetivos: Analizar la prevalencia de comorbilidades endocrino-metabólicas en pacientes con EPOC y los factores de riesgo que favorecen la aparición de dichas enfermedades. Métodos: Se desarrolló una estrategia de búsqueda exhaustiva de la literatura limitada a los últimos diez años, en las bases de datos PubMed, Scopus y ScienceDirect, usando las palabras clave "endocrine metabolic disorders AND COPD", "endocrine disorders AND COPD" y "metabolic disorders AND COPD". ". En el análisis bibliográfico se excluyeron aquellos artículos cuyo título o contenido no se correspondía con el objetivo del presente estudio, así como los artículos duplicados en las bases de datos. Finalmente, tras una profunda lectura crítica, fueron seleccionados y analizados 17 artículos. Resultados: El análisis de los artículos ha mostrado una relación significativa entre la EPOC y la presencia de alteraciones endocrino-metabólicas tales como diabetes mellitus, síndrome metabólico, obesidad, osteoporosis e hipogonadismo. Los autores coinciden en la alta prevalencia de estas comorbilidades, que influyen de forma diferente en el desarrollo de la EPOC. Conclusiones: Debido a la alta prevalencia y asociación con la EPOC, estas comorbilidades han de ser tenidas en cuenta por el profesional sanitario, ya que pueden afectar su abordaje, intervención y resultados.

Nursing homes: impact of sleep disturbances on functionality.

Previous studies have demonstrated that sleep-related problems are common in the aging process. Such problems are greater in nursing home residents than other elderly people. This study had the following objectives: (1) establish the clinical profile of nursing home residents according to their quality of sleep and intake of hypnotic medication, (2) assess participants' functionality in relation with their quality of sleep and (3) correlate participants' functional status with their quality of sleep. The study sample was composed of 334 nursing home residents. Results showed a high percentage (72.1%) of poor sleepers in nursing homes. We found significant differences (p<0.05) in functionality according to quality of sleep and a significant correlation (p<0.05) between the subscales of the Pittsburgh Sleep Quality Index (PSQI) and most subareas of the Functional Status Questionnaire (FSQ). The study showed the existence of a relationship between sleep quality and functional status in elderly people living in nursing homes. These results suggest that additional precautions should be taken when managing nursing home residents with sleep disturbances.

Endocrinometabolic disorders in chronic obstructive pulmonary disease / Alteraciones endocrinometabólicas en la enfermedad pulmonar obstructiva crónica

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterized by the presence of chronic airflow obstruction and associated endocrinometabolic disorders, which usually worsen the clinic and prognostic of the patients. Therefore, in-depth knowledge of these prevalent disorders in patients with COPD is relevant to develop preventive measures and early detection. PURPOSE: To analyze the prevalence of endocrinometabolic diseases that occur in COPD subjects and their related risk factors. METHODS: We carried out a bibliographic search of the bibliographic resources of the last 10 years, including PubMed, Scopus and Science Direct databases. Words used were: "endocrine metabolic disorders AND COPD", "endocrine disorders AND COPD" and "metabolic disorders AND COPD". The bibliographical analysis was made in two steps. During the first phase, we excluded those articles in which the title or their content did not correspond with the objective settled; during the second phase, we deleted all the references duplicated in both databases. Finally, 17 articles after full-text critical appraisal were maintained. RESULTS: After reviewing the articles, we found a significant relationship between diabetes mellitus, metabolic syndrome, obesity, osteoporosis, hypogonadism and COPD. Different authors have reported a higher prevalence of these comorbidities, influencing the development of COPD. CONCLUSIONS : Due to the high prevalence and association with COPD, these comorbidities have to be considered by the health professionals related to the COPD patients. Better understanding of the endocrinometabolic disorders related to COPD can influence the treatment and the outcome of patients (AU)

INTRODUCCIÓN: La enfermedad pulmonar obstructiva crónica (EPOC) se caracteriza por obstrucción crónica del flujo aéreo y se asocia frecuentemente a alteraciones endocrino-metabólicas que empeoran la situación clínica del paciente y su pronóstico. El conocimiento en profundidad de estas alteraciones en los pacientes con EPOC permite llevar a cabo medidas preventivas, detección temprana e intervenciones nutricionales adecuadas. OBJETIVOS: Analizar la prevalencia de comorbilidades endocrino-metabólicas en pacientes con EPOC y los factores de riesgo que favorecen la aparición de dichas enfermedades. MÉTODOS: Se desarrolló una estrategia de búsqueda exhaustiva de la literatura limitada a los últimos diez años, en las bases de datos PubMed, Scopus y ScienceDirect, usando las palabras clave "endocrine metabolic disorders AND COPD", "endocrine disorders AND COPD" y "metabolic disorders AND COPD". ". En el análisis bibliográfico se excluyeron aquellos artículos cuyo título o contenido no se correspondía con el objetivo del presente estudio, así como los artículos duplicados en las bases de datos. Finalmente, tras una profunda lectura crítica, fueron seleccionados y analizados 17 artículos. RESULTADOS: El análisis de los artículos ha mostrado una relación significativa entre la EPOC y la presencia de alteraciones endocrino-metabólicas tales como diabetes mellitus, síndrome metabólico, obesidad, osteoporosis e hipogonadismo. Los autores coinciden en la alta prevalencia de estas comorbilidades, que influyen de forma diferente en el desarrollo de la EPOC. CONCLUSIONES: Debido a la alta prevalencia y asociación con la EPOC, estas comorbilidades han de ser tenidas en cuenta por el profesional sanitario, ya que pueden afectar su abordaje, intervención y resultados (AU)