Impact of pulmonary rehabilitation on exercise capacity, health-related quality of life, and cardiopulmonary function in lung surgery patients: a retrospective propensity score-matched analysis.

Background: Pulmonary rehabilitation is considered beneficial for patients undergoing lung surgery, yet its specific impacts on exercise capacity, health-related quality of life (HRQL), and cardiopulmonary function require further elucidation. This study aimed to evaluate the effect of PR on these outcomes in patients undergoing lung surgery using a retrospective propensity score-matched analysis. Methods: We retrospectively analyzed 420 patients with non-small cell lung cancer (NSCLC) who underwent lung surgery from January 2022 to May 2024. Among these, 84 patients received PR while 336 did not (control group). Propensity score matching (PSM) at a 1:1 ratio yielded 46 patients in each group. Baseline characteristics, spirometry, cardiopulmonary exercise testing, respiratory muscle strength, HRQL, and muscle measurements were assessed pre-and post-surgery. Results: Before PSM, significant differences existed between groups, with the PR group being older and having different pulmonary function baselines. After PSM, groups were well-balanced. Postoperatively, the PR group showed significant improvements in FEV1/FVC (64.17% vs. 50.87%, p < 0.001), FEV1 (2.31 L/min vs. 1.75 L/min, p < 0.001), and predicted FVC percentage (88.75% vs. 68.30%, p < 0.001). Cardiovascular responses showed a lower CI during exercise in the PR group post-PSM (6.24 L/min/m2 vs. 7.87 L/min/m2, p < 0.001). In terms of exercise capacity, the PR group had higher maximal WR percentage (104.76% vs. 90.00%, p = 0.017) and peak VO2 (1150.70 mL/min vs. 1004.74 mL/min, p = 0.009). PR also resulted in less leg soreness and lower total CAT scores postoperatively. Muscle measurements indicated significantly smaller reductions in ΔHUESMCSA and percentage change in the PR group. Conclusion: Pulmonary rehabilitation significantly enhances exercise capacity, HRQL, and cardiopulmonary function in patients undergoing lung surgery. It also mitigates postoperative muscle loss, underscoring its importance in the postoperative management of lung surgery patients.

A case of congenital bronchial atresia with tracheobronchial stenosis caused by emphysema: Successful management with thoracoscopic surgery.

Introduction: Congenital bronchial atresia (CBA), as a rare developmental abnormality of the lung, is usually asymptomatic and is accidently discovered in most cases. Currently, no standardized guidelines for the treatment or management of CBA have been established. Case presentation: A 22-year-old male soldier was referred to Shanghai Changhai Hospital, The First Affiliated Hospital of Naval Medical University due to chest tightness and shortness of breath after repeated strenuous activities. Contrast-enhanced computed tomography (CT) revealed an 18mm × 11mm solitary, well-circumscribed, and solid nodule with no enhancement in the right upper lobe (RUL), and emphysematous changes distributed throughout the RUL. A flexible bronchoscopic examination showed extrinsic compression stenosis in the bronchial opening of the right middle lobe (RML). After three-dimensional (3D) reconstruction CT and a multidisciplinary consultation, a diagnosis of CBA in the anterior segment (B3) of RUL was established. Subsequently, thoracoscopic right upper lobectomy was performed and resulted in an improved respiratory capacity 6 months after surgery. To date, the patient has good quality of life without any complication. Conclusion: This study underscores the role of bronchoscopy, 3D reconstruction CT, and a multidisciplinary consultation in the diagnosis of CBA, and highlights that a thoracoscopic intervention should be considered in such case.

Baduanjin is Better Balance Training Compared to Walking: A Cross-Sectional Study Based on Center of Gravity Trajectories.

BACKGROUND:  It has already been demonstrated by previous studies that Baduanjin training can improve the body's balance. However, its biomechanical mechanism remains unknown. Center of gravity (COG) trajectory analysis is an essential biomechanical test to explore the balance ability of the human body. Previous studies have not used the COG trajectory analysis technique to research Baduanjin training. The study utilizes COG trajectory analysis to analyze the trajectory of COG during Baduanjin training and compare it with that of walking, which is a common exercise for improving balance and aerobic ability, to determine if Baduanjin exercises affect the COG more than walking. MATERIALS AND METHODS:  Eight healthy female college students performed the walking and the eight forms of Baduanjin, a total of nine motions. The lower body kinematics were captured by the Vicon Motion Capture and Analysis System, while the kinetic data were acquired by the Kistler 3D Force Platform. The data were imported into Visual 3D to process the trajectory of the COG displacement amplitude, velocity, and acceleration of each motion. The COG horizontal envelope areas were calculated by Origin 9.0 Software (Origin Lab, Northampton, Massachusetts, USA) . RESULTS: Specific motions of Baduanjin provided significantly higher COG displacement amplitude, velocities, and acceleration training than walking. The F2 and F5 motions could provide a larger COG horizontal envelope area than walking. On the x-axis, F2 provided a greater COG displacement amplitude than walking, F1, F2, and F5 provided greater velocities, while all the motions provided greater accelerations. On the y-axis, all the motions except F2 provided greater COG displacement velocities and accelerations than walking. On the z-axis, F1-7 provided a greater COG displacement amplitude than walking, all the motions provided greater velocities, while all the motions except F2 provided greater accelerations. CONCLUSION: Baduanjin training provides a more intense COG perturbation than walking, which may be a more challenging balance training than walking.