Free-living physical activity characteristics, activity-related air trapping and breathlessness, and utilization of transtheoretical constructs in COPD: A pilot study.

OBJECTIVE: Many patients with Chronic Obstructive Pulmonary Disease (COPD) experience air trapping at rest and during exercise. This study examined the relationship between air trapping and air hunger breathlessness during acute physical activity (PA) engagement. In addition, we examined free-living movement patterns of COPD patients, as well as their utilization of psycho-behavioral factors known to influence PA behavior. METHODS: Ten current or former smokers with COPD (M age=70 years) participated. Baseline pulmonary function measurements were gathered and participants completed a graded exercise test (2, 2.5, and 3 mph; 5 min each). At each stage, air hunger breathlessness was rated using the Multidimensional Dyspnea Profile (MDP). Inspiratory capacity (IC) measurements were also collected to monitor air trapping. Data regarding PA and sedentary behavior was measured over 7 days using accelerometry. RESULTS: The results (mean [SD]) showed air trapping during exercise. IC levels across baseline and the 3 stages, respectively, were 1.66 (.62) L, 1.33 (.52) L, 1.35 (.58) L, and 1.28 (.57) L. A significant difference occurred between baseline and stage 1 (p=.01). Coincident low-to-moderate air-hunger breathlessness was observed across baseline and the 3 stages (Likert scale 0-10): 0.44 (1.01), 1.44 (2.12), 2.33 (2.59), and 2.67 (2.64). Participants utilized few PA-related psycho-behavioral strategies and spent the majority (67.4%) of their waking hours in sedentary behavior, while only engaging 5 min a day of moderate intensity PA and 0 min at vigorous-intensity PA. CONCLUSIONS: These COPD patients were intolerant to low levels of exercise intensity, resulting in little PA engagement, and also utilized few PA-related psycho-behavioral strategies.

Association between depression and tinnitus in a nationally representative sample of US older adults.

OBJECTIVES: Few population-based studies examining the association between tinnitus and depression among older adults have been conducted. Therefore, the purpose of this study was to examine the association between tinnitus and depression among a nationally representative sample of US older adults. METHODS: Data from the 2005-2006 National Health and Nutrition Examination Survey was used. 696 older adults (70-85 yr) completed questionnaires on tinnitus and depression, with depression assessed using the Patient Health Questionnaire-9. RESULTS: After controlling for firearm use, age, gender, race-ethnicity, cardiovascular/stroke history, diabetes, smoking status, body mass index, physical activity, noise exposure and elevated blood pressure, there was a significant positive association (beta coefficient: 1.28, 95% CI: 0.26-2.29, p = 0.01) between depression and tinnitus being at least a moderate problem, suggesting that those who perceived their tinnitus to be a moderate problem were more likely to be depressed than those perceiving it to be a small or no problem. Additionally, after adjustments, those who were bothered by tinnitus when going to bed were 3.06 times more likely to be depressed than those who were not bothered by tinnitus when going to bed (OR = 2.44, 95% CI: 1.03-5.76, p = 0.04). CONCLUSION: These findings suggest that individuals who perceive their tinnitus to be a problem or have problems with tinnitus when going to bed may be in need of intervention to prevent or reduce their depression symptoms so as to ensure that other areas of their life are not negatively influenced.

Prehabilitation and quality of life three months after total knee arthroplasty: a pilot study.

Knee osteoarthritis (OA), which affects over 27 million Americans, decreases the individual's quality of life through decreasing mobility, deconditioning, reducing functional ability, and increasing knee pain. The present aim was to assess whether such patients engaging in exercise prior to surgery ("prehabilitation"; preoperative exercise intervention) rate higher quality of life 3 mo. after their surgery compared with ratings by patients who did not engage in prehabilitation. Standard populations consist of OA patients that do not participate in any preoperative exercise programs, such as a prehabilitation exercise intervention. 18 knee osteoarthritis patients were randomly assigned to a control or a prehabilitation group. The latter group participated in an exercise intervention three times per week, once at home and twice at the physical therapy lab, for 8 wk. prior to their surgery. The control group participated in their usual preoperative care prescribed by the physician for all patients. Eight health-related quality of life domains were assessed at 3 mo. post surgery. These preliminary findings suggest efficacy of prehabilitation in facilitating quality of life of total knee arthroplasty (TKA) patients 3 mo. after surgery.

Prehabilitation versus usual care before total knee arthroplasty: A case report comparing outcomes within the same individual.

This case report compared pre- and postoperative functional ability, knee strength, and pain of a female who underwent two separate total knee arthroplasty (TKA) procedures. The female patient was part of a larger research study. The first surgery on the right knee was preceded with usual care and the second surgery on the left knee was preceded by prehabilitation. Functional ability was assessed by a 6-minute walk, chair raises, and the time required to ascend and descend stairs. Knee extension and flexion isokinetic strength was assessed using the KinCom Isokinetic Dynamometer. Pain was assessed using the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC). Functional abilities, knee strength, and pain were assessed at baseline measurements 4 weeks before surgery, 1 week before surgery, and at 1 and 3 months post surgery during each TKA procedure. Results indicate that the prehabilitation intervention had a favorable impact on improving functional ability up to 30%, increasing knee strength by 50% and decreasing pain prior to the left knee TKA. For this patient, prehabilitation increased functional ability and strength prior to surgery. Gains in strength were maintained in the nonsurgical knee after surgery. These findings indicate that prehabilitation may be effective at facilitating the rehabilitation following a TKA.