Effectiveness of technology-aided education on self-efficacy among individuals post pulmonary surgery: A randomized controlled trial.

BACKGROUND: Patient education is an effective tool in enhancing compliance and comprehension to therapy. Preoperative video-based education (VBE) on knowledge and understanding of surgical procedures and physical therapy provides an insight into the essential need for treatment adherence and early post-operative recovery. Self-efficacy (SE) is an individual self-belief about one's ability to cope and is denoted as a sign of healthy behavior and empowerment. Although little is known about VBE and self-efficacy (SE) in rehabilitation of pulmonary surgery patients. The objective was to assess the influence of VBE in pulmonary rehabilitation on SE post pulmonary surgery patients using the Manipal Self Efficacy Questionnaire (MSEQ). METHODS: Study design: Mixed methods pilot study. The MSEQ and educational video were designed and developed for this study. Piloting was conducted with the MSEQ (CVI = 0.95) and educational video (CVI = 1). After approval from the ethics committee, written informed consent was obtained from twenty preoperative pulmonary surgery patients were randomized to two groups. The control group (n = 30) received routine post-operative exercises and experimental group (n = 30) received preoperative VBE along with exercises. RESULTS: Validation of MSEQ and educational video was derived as per content validation index. Mann- Whitney U test and Wilcoxon signed rank test were used to compare the groups. SE scores in the experimental group was higher than the control (p = 0.004). DISCUSSION AND CONCLUSION: VBE on PR improved SE of the patients after pulmonary surgery. The study's main limitation was the difficulty in attaining the desired sample size because it was a time-bound study.

Patient education for individuals with Interstitial Lung Disease: A scoping review.

Objectives: Interstitial Lung Disease (ILD) is a severe and rapidly progressing disease with a high fatality rate. Patient education (PE) has been demonstrated to promote long-term adherence to exercise and lifestyle improvements by assisting patients in developing self-management techniques. Our scoping review's goal was to chart out the prevailing level of research about the content, processes, and effectiveness of PE for patients with ILD. Methods: The relevant databases were searched using the rules provided by Arksey and O'Malley in 2005 and the Joanna Briggs Institute reviewers' manual 2015: an approach for JBI scoping reviews. Individuals with ILD, published in English between the years of inception and 2020, and describing PE administered by various healthcare practitioners were among the 355 studies found and reviewed. Thirteen studies met these criteria. Results: PE delivery process, delivery techniques, quality of life assessments, common PE themes, and healthcare professional participation were all recognized and cataloged. Conclusion: Despite the fact that healthcare professionals (physicians, nurses, and physiotherapists) provide PE to patients with ILD regularly, the PE provided varies greatly (contents of PE, process of delivery and delivery techniques). During the scoping review, a significant variation in the themes was addressed. They could not provide any evidence-based specific recommendations for all healthcare practitioners due to the studies' heterogeneity and lack of effectiveness measures.

Therapeutic approaches for the treatment of Interstitial Lung Disease: An exploratory review on molecular mechanisms.

BACKGROUND: Interstitial Lung Diseases (ILDs) are characterized by shortness of breath caused by alveolar wall inflammation and/or fibrosis. OBJECTIVE: Our review aims to study the depth of various variants of ILD, diagnostic procedures, pathophysiology, molecular dysfunction and regulation, subject and objective assessment techniques, pharmacological intervention, exercise training and various modes of delivery for rehabilitation. METHOD: Articles are reviewed from PubMed and Scopus and search engines. RESULTS: ILD is a rapidly progressing disease with a high mortality rate. Each variant has its own set of causal agents and expression patterns. Patients often find it challenging to self-manage due to persistent symptoms and a rapid rate of worsening. The present review elaborated on the pathophysiology, risk factors, molecular mechanisms, diagnostics, and therapeutic approaches for ILD will guide future requirements in the quest for innovative and tailored ILD therapies at the molecular and cellular levels. CONCLUSION: The review highlights the rationale for conventional and novel therapeutic approaches for better management of ILD.

Influence of home-based pulmonary rehabilitation program among people with interstitial lung disease: A pre-post study.

INTRODUCTION: Access to interstitial lung disease programs may not be available in rural settings. Home-based pulmonary rehabilitation (PR) programs have been proposed as an alternative to hospital-based programs. METHOD: Forty participants with ILD underwent a structured unsupervised home-based pulmonary rehabilitation program from September 2020 to September 2022. Quality of life was assessed using St. George Respiratory Questionnaire (SGRQ) and functional capacity using 6-minute walk test (6MWT). The outcome measures were assessed at baseline and 4 weeks post-unsupervised home-based PR program. RESULT: We recruited 40 participants with ILD. There was statistically significant improvement in the 6-minute walk distance (353.8 m and 368 m, effect size - 0.5, p ≤ .001) and quality of life using SGRQ total score (38.6 and 42.35, effect size - 2.5, p ≤ .001) between before and after receiving home-based PR among all 40 participants with ILD. CONCLUSION: Four weeks of home-based PR program, using minimal resources, deliver short-term improvements in functional exercise capacity and quality of life among ILD participants. Our home-based PR program resulted in a quarter percentage improvement in functional capacity, and we believe that if consistency is maintained, it will result in similar changes corresponding to the already established Minimal Clinically Important Difference (MCID) of 35 m.

Prenatal Learning and Memory: Review on the Impact of Exposure.

BACKGROUND: Prenatal Learning is a topic still debated for its existence, although the concept is well known since ancient times. OBJECTIVE: The present review highlights the impact of various stimuli on learning and memory in prenatal and postnatal life. METHODS: For review, various articles from preclinical and clinical studies providing early pieces of evidence of prenatal learning to date were included based on the relevancy of the databases, namely, Scopus, Pubmed, and Google Scholar. RESULTS: Learning is the process of acquiring skills/ preferences/ habits from the experiences of the exposures of the past. These exposures are the stimuli, which help in categorizing learning into associated or nonassociated learning. The stimuli of adults related to auditory, gustatory, olfactory, visual, touch, etc. are also accessible to the prenatal life in utero either directly or indirectly through the mother. The effects of these stimuli are remarkable during prenatal life and can be seen clearly in infants. These stimuli play an important role in prenatal learning and contribute to neuronal development. The present review summarizes the pieces of evidence for each of these types of learning & their impact on the ex utero life, a futuristic view & the scope of understanding prenatal learning. The review also elucidates the factors affecting prenatal learning. CONCLUSION: Studies from clinical and preclinical studies reflected the impacts of several aspects of an infant's life and the memory created during prenatal life was found to be most likely carried on to postnatal life.

Global mapping of exercise interventions among COVID-19 survivors: protocol for a scoping review.

INTRODUCTION: The COVID-19 pandemic has posed an unparalleled threat to all dimensions of human health and well-being. The Pan American Health Organization has acknowledged the crucial role of rehabilitation therapies for COVID-19 and emphasised the importance of exercise programmes for COVID-19 survivors. This scoping review outlines our strategy for systematically reviewing published and unpublished literature to investigate the volume of evidence for exercise interventions for COVID-19 survivors. METHODS AND ANALYSIS: This scoping review will be conducted based on the framework developed by Arksey and O'Malley. Six databases (PubMed/Medline, Scopus, Web of Science, Cochrane Central, ProQuest and CINAHL) will be searched in August 2022 and articles will be considered for inclusion published till July 2022. Studies will be screened by two independent reviewers at the title/abstract and full-text screening stages, as well as data extraction and critical assessment. Data will be extracted in a data extraction form and presented as figures and tables with narratives. This scoping review will give a thorough understanding of the current literature on exercise interventions for COVID-19 survivors, as well as identify knowledge gaps that will guide future research. Preliminary searches will be conducted after the publication of this scoping review protocol. ETHICS AND DISSEMINATION: No human or animal participants were involved in this review. Therefore, ethical committee approval is not required. Transparency will be followed at every review stage. Review findings will be disseminated through peer-review publications or through conference presentations.

Effect of a home-based pulmonary rehabilitation program on functional capacity and health-related quality of life in people with interstitial lung disease - A randomized controlled trial protocol.

BACKGROUND: Centre-based pulmonary rehabilitation is an effective, non-pharmacological intervention in improving outcomes for people with interstitial lung disease (ILD). Home-based pulmonary rehabilitation (PR) is a lower-cost rehabilitation alternative for people with chronic respiratory diseases. The aims of this study are to evaluate the efficacy of home-based PR on functional capacity and health-related quality of life in people with ILD, as well as to assess changes in dyspnea and fatigue, muscle strength, activities of daily living, depression, and anxiety after completing a home-based PR program. METHODS: Ninety-six individuals with ILD will be randomly assigned to either an intervention group (home-based PR exercise training program) or a control group (usual care). An assessor blind to group allocation will measure the 6-min walk distance, peripheral muscular strength, health-related quality of life, dyspnoea, anxiety and depression, fatigue, activities of daily living, upper limb and lower limb endurance at baseline, at program completion one month, and three months after the intervention. DISCUSSION: If home-based PR programs are proven to be beneficial over time, they will address a critical gap by giving a readily accessible and viable choice of rehabilitation to people with ILD, enabling more people to participate in an exercise program.

COVID-19 Preventive Measure: A Study on "MASK-A Boon or a Bane".

Background: Mask wearing can restrict the spread of respiratory viral transmission during the third wave of the COVID-19 pandemic. Globally, governments have emphasized its use in workplaces and public areas to prevent the transmission routes of corona virus. In spite of the current awareness in the general population, the stringency of wearing the mask lies as an individual's choices. Subject and Methods. This research work discusses available studies on the types and comparison of masks in the market for use. It includes a short survey conducted with 1,173 anonymized healthy participants primarily devoid of comorbidities. The survey includes the effects of mask wearing, while outdoor with minimal activities like walking and with mild activities like jogging and stretching. Our research further discusses various health effects of wearing a mask, including cardiac output, hypoxemia, hypoxia, and dyspnoea, and how such situations that pose a threat can be consciously avoided. Results: It was found that the majority of people use cloth/fabric reusable mask. There remains scope for better-designed masks and improving health in the mass population by inculcating healthy breathing habits and other relevant exercises that can help people cope up better in this fight against the deadly virus at a larger scale. Conclusion: For most of the survey questions, there was significant correlation between gender and the related responses as there was no significantly observable difference in the nonparametric, unpaired analyses of responses. The main objective of this research work is to initiate more discussions and enhance awareness in natural ways of staying healthy during the pandemic emphasizing mask use. Further progress in this aspect remains a whole new area for future exploration.

Effect of home-based pulmonary rehabilitation on functional capacity in people with idiopathic pulmonary fibrosis-a systematic review protocol.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is one of the common types of interstitial lung disease having high prevalence and mortality worldwide. As a result of patient-centred hindering factors of adherence to centre-based pulmonary rehabilitation (PR), home-based PR is an alternate mode of rehabilitating individuals with IPF. This systematic review will evaluate the effectiveness of unsupervised home-based PR on functional capacity and health-related quality of life (HRQoL) in individuals with IPF. METHODS: Clinically stable, high resolution computed tomography and physician diagnosed IPF participants having modified Medical Research Council score below 5 will be considered for the systematic review. Studies involving home-based PR as an intervention to treat individuals with IPF will be considered. Randomised controlled trials and quasi-randomised studies (with two groups followed up) are eligible to be included. Outcomes of our interest are functional capacity (6-min walk distance, shuttle walk test and incremental shuttle walk test) and secondary outcome measure would include assessment of quality of life and adverse effects of intervention. Electronic databases such as SCOPUS, Medline (PubMed and Web of Science), PEDRo and CINAHL will be searched using database specific terms. Additionally, forward and backward citations of included studies will be searched to identify potential records. Two review authors, independently, will conduct the screening, data extraction using a customised standard tool, and critical appraisal using Cochrane Risk of Bias 2 tool of included studies. If data permits, meta-analysis will be conducted. In case of substantial heterogeneity, we will do a narrative synthesis. Subgroup analysis will be undertaken based on various contextual and interventional factors. DISCUSSION: This review will provide comprehensive evidence on the effectiveness of unsupervised home-based PR to physiotherapists, policy makers and researchers who are interested in IPF management. Findings from this review may guide the development and evaluation of more robust evidence based home-based PR that aimed to improve functional capacity among people with IPF. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020213883.

Contrasting effects of three breathing techniques on pulmonary function, functional capacity and daily life functional tasks in patients following valve replacement surgery- A pilot randomized clinical trial.

BACKGROUND: Valve replacement surgeries affect the physiological mechanisms of patients leading to various postoperative pulmonary complications. Lung expansion therapy consisting of numerous techniques is routinely used for the prevention and treatment of these complications. OBJECTIVES: Our study aimed to compare the effects of diaphragmatic breathing (DB), flow (FS) and volume-oriented incentive spirometer (VS) in patients following valve replacement surgery. METHODS: 29 patients posted valve replacement surgeries were randomly assigned to VS, FS and DB groups. Patients underwent preoperative training and seven-day rehabilitation post-surgery. Pulmonary function tests were performed before surgery and for seven days afterward. On the seventh postoperative day, patients performed a six-minute walk test and completed a functional difficulties questionnaire (FDQ). RESULTS: Pulmonary function test values reduced in all three groups postoperatively when compared to the preoperative values but improved by the seventh postoperative day (p < 0.05). On comparing the seventh postoperative day values to the preoperative values, the VS group had no significant difference (p = 1.00) (Forced Vital Capacity- % change: DB-37.76, VS-1.59, FS-27.98), indicating that the value had nearly returned to the baseline. As compared to the DB and FS groups, FVC showed a greater improvement in the VS group (p = 0.01 and p = 0.06 respectively). No significant differences were observed between groups for distance walked (p > 0.05), however, FDQ scores demonstrated positive changes in favor of VS when contrasted with FS or DB (p < 0.05). CONCLUSION: Diaphragmatic breathing, flow or volume-oriented spirometer could improve pulmonary function in the postoperative period. The volume-oriented spirometer, however, was found to be the most beneficial among the three techniques in improving patients' pulmonary function and daily life functional tasks. Further research is warranted to confirm these findings.

Effects of three pulmonary ventilation regimes in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial.

The aim was to compare the effect of diaphragmatic breathing exercise (DBE), flow- (FIS) and volume-oriented incentive spirometry (VIS) on pulmonary function- (PFT), functional capacity-6-Minute Walk Test (6 MWT) and Functional Difficulties Questionnaire (FDQ) in subjects undergoing Coronary Artery Bypass Graft surgery (CABG). The purpose of incorporating pulmonary ventilator regimes is to improve ventilation and avoid post-operative pulmonary complications. CABG patients (n = 72) were allocated to FIS, VIS and DBE groups (n = 24 each) by block randomization. Preoperative and postoperative values for PFT were taken until day 7 for all three groups. On 7th postoperative day, 6 MWT and FDQ was analyzed using ANOVA and post-hoc analysis. PFT values were found to be decreased on postoperative day 1(Forced Vital Capacity (FVC) = FIS group-65%, VIS group-47%, DBE group-68%) compared to preoperative day (p < 0.001). PFT values for all 3 groups recovered until postoperative day 7 (FVC = FIS group-67%, VIS group-95%, DBE group-59%) but was found to reach the baseline in VIS group (p < 0.001). When compared between 3 groups, statistically significant improvement was observed in VIS group (p < 0.001) in 6 MWT and FDQ assessment. In conclusion, VIS was proven to be more beneficial in improving the pulmonary function (FVC), functional capacity and FDQ when compared to FIS and DBE.

Coping strategies for obese individuals with obstructive sleep apnea during COVID-19 pandemic: A narrative review.

BACKGROUND: Patients infected with SARS-CoV-2- having pre-existing non-communicable diseases (NCDs)- are at a higher risk of complications. Obesity is one of the proven risk factors causing NCDs and can influence outcomes of COVID-19 patients. It is closely related to obstructive sleep apnea (OSA). The increased risk of COVID-19 and reduced access to treatment of non-COVID conditions during the pandemic may increase the stress in obese patients with OSA. This situation makes it necessary for them to cope with their condition by themselves. This review aimed at the effect of this pandemic on these patients and coping strategies for them. METHODS: Databases like PubMed and Scopus were searched using a combination of key words. Full-text articles meeting the inclusion criteria were selected. RESULTS: The search yielded eight studies, discussing about the potential interactions between the COVID-19, obesity and OSA, the impact of COVID-19 on them, and management of these patients. CONCLUSIONS: Increased prevalence of COVID-19 was found among obese patients with OSA. The fear of COVID-19 and shift of health care workers to manage COVID-19 patients has affected their regular visits to the hospital. However, there is lack of coping strategies for them, which should soon be established for these patients.