Investigation of the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in unilateral breast cancer surgery survivors: a cross-sectional study.

PURPOSE: Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis. RESULTS: Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05). CONCLUSION: The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

Investigation of the dual-task performance and affecting factors in female patients with fibromyalgia syndrome.

Recent studies report that dual-task (DT) performance might be affected in patients with fibromyalgia syndrome (FMS). This cross-sectional study aims to compare the DT performance in female patients with FMS and healthy controls, and to investigate the DT-related factors in these patients. This study was conducted at a university hospital between November 2021 and April 2022. Forty females aged 30-65, diagnosed with FMS, and 40 aged-matched pain-free healthy controls were included. All participants performed the Timed Up and Go Test under a single task (ST) and a cognitive DT condition, and the DT cost was calculated. The following evaluations were applied; The six-minute walk test, Baecke Habitual Physical Activity Questionnaire, Multidimensional Fatigue Inventory-20, Toronto Alexithymia Scale, Trail Making Test, and the Revised Fibromyalgia Impact Questionnaire. As a result of the study, the patient group showed lower performance than controls in both, ST and DT conditions (p < .05). Disease duration, pain and fatigue severity, functional capacity, leisure time and physical activity total scores, alexithymia scores, health status, and cognitive variables were correlated with DT performance in the patient group (p < .05). According to our results, we consider that the rehabilitation approach for females with FMS should take into account DT and related characteristics.

Psychometric Properties of the Turkish Adaptation of the Yale Physical Activity Survey.

This study aimed to examine the convergent validity and test-retest reliability of the Turkish version of the Yale Physical Activity Survey (YPAS-TR). Eighty-one volunteer older adults were included in the study. Test-retest reliability was evaluated using the intraclass correlation coefficient. Correlation coefficients between YPAS-TR and Physical Activity Scale for the Elderly (PASE), Short Form-36, and Short Physical Performance Battery were examined for convergent validity. Acceptable intraclass correlation coefficient values were reached for YPAS-TR energy expenditure, total physical activity time and summary, vigorous, leisurely walking, moving, standing, and sitting indices (intraclass correlation coefficient = .96-.99). There was a moderate correlation between energy expenditure and total physical activity time with PASE (leisure time activities), PASE (household activities), and PASE (total) (r = .478, r = .468, r = .570, r = .406, r = .490, r = .550, respectively, p < .001). Also, a weak correlation was found between summary and leisurely walking index with PASE (household activities), standing index with PASE (leisure time activities), and PASE (total) (r = .285, p = .010; r = .257, p = .021; r = .238, p = .033; r = .283, p = .010; respectively). The results of the study suggest that the YPAS-TR is a valid and reliable measurement tool that can be used to assess the physical activity patterns of Turkish older adults.

Is the repeated pulmonary rehabilitation program as effective as the first one in COPD patients?

Introduction: Although it is known that the effects of pulmonary rehabilitation (PR) programs in patients with chronic obstructive pulmonary disease (COPD) decrease over time, the results of the repeat PR programs are contradictory. Our study aimed to compare the effectiveness of the initial and the repeat PR programs on functional outcomes in COPD patients. Materials and Methods: Thirty two COPD patients who completed a second PR program were included in our retrospective cohort study. Eight-week PR program was applied to the patients twice with at least a one-year interval in between. mMRC Dyspnea Scale, Six-Minute Walk Test, Hospital Anxiety and Depression Scale, 36 Item Short Form Survey (SF-36), and St. George's Respiratory Questionnaire (SGRQ) were performed before and after both programs. The gains from the initial and the repeated programs were compared. Result: Six-minute walk distance, dyspnea, and quality of life improved following both programs (p<0.05). Improvements in six-minute walk distance (p= 0.009), dyspnea (p= 0.003), and SGRQ quality of life (p= 0.037 for activity score, p= 0.050 for total score) were found to be significantly higher in the initial PR program. Conclusions: Although many of the gains obtained from the repeated PR programs were similar to the initial PR program, the improvements in walk distance, perception of dyspnea, and quality of life obtained in the initial PR program were higher compared to the repeated PR program.

Comparing the effect of pulmonary rehabilitation in patients with uncontrolled and partially controlled asthma.

OBJECTIVE: Pulmonary rehabilitation (PR) is an important therapeutic approach in asthmatic patients. Lack of asthma control is associated with high morbidity, poor health outcomes, and decrease in quality of life (QOL). However, there is no clear information about the effectiveness of PR in patients with differing levels of asthma control. This study aimed to compare the efficacy of PR in patients with uncontrolled and partially controlled asthma. METHODS: Before undergoing an 8-week outpatient PR program, patients were classified according to the asthma control test (ACT) as having partially controlled asthma or uncontrolled asthma. Changes in asthma control, exercise capacity, dyspnea perception, pulmonary function tests, arterial blood gas analysis, QOL, and psychological symptoms before and after PR were compared between groups. RESULTS: A total of 49 patients, 21 of whom were in partially controlled and the rest 28 were in uncontrolled asthma, participated in the study. After PR, asthma control perceived dyspnea, exercise capacity, QOL, anxiety, and depression significantly improved in both groups (p < 0.05). When the two groups were compared in terms of the benefits of PR, the improvement in ACT score was significantly greater in patients with uncontrolled asthma than in partially controlled asthma (p < 0.001), whereas the improvements in other parameters were similar between groups (p > 0.05). CONCLUSIONS: Improvement in asthma control is greater in patients with uncontrolled asthma than in patients with partially controlled asthma after PR. Therefore, patients with uncontrolled asthma, in particular, should be given opportunities to benefit from PR programs.

The effect of comorbidity severity on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients.

CLINICAL TRIAL NUMBER: NCT03319108.

Why are COPD patients unable to complete the outpatient pulmonary rehabilitation program?

This study aims to compare demographic and clinical characteristics of chronic obstructive pulmonary disease (COPD) patients who complete and fail to complete outpatient pulmonary rehabilitation (PR) program and to determine the reasons for not completing the program. Patients with COPD referred to the PR program were divided into two groups: Those who completed the program were classified as group 1 and those who did not complete were classified as group 2, and their data were compared. Patients who failed to complete the program were contacted through phone and asked why they ceased their participation in the program. In group 2, number of smoker patients and patients using nebulizer and receiving long-term oxygen treatment, emergency admissions, and dyspnea perception were higher ( p = 0.003, p < 0.001, p = 0.033, p = 0.011, p < 0.001, respectively); forced expiratory volume in one second (%) value, exercise capacity, and quality of life were lower ( p = 0.024, p = 0.001, p = 0.014, respectively). When considered from the sociodemographic perspective, group 2 had a lower education level and a higher rate of living alone ( p < 0.001). Factors impairing the program compliance were lack of motivation (49.0%), transportation problems (23.8%), COPD exacerbation (18.4%), work-related reasons (4.8%), and hospitalization (4.1%), respectively. Smokers and severe COPD patients fail to complete PR program due to various reasons, especially lack of motivation. It is very important for health practitioners to inform patients accurately and adopt a positive attitude.

The effects of smoking on body composition, pulmonary function, physical activity and health-related quality of life among healthy women.

INTRODUCTION: Smoking leads to more respiratory symptoms and negative effects on the health-related quality of life (HRQOL) in women than men for the same smoking burden. However, the relationship between smoking and body composition and its influencing factors remains unclear. In this study, we aim to investigate the effects of smoking on body composition, pulmonary function, physical activity and health-related quality of life (HRQOL) among healthy women. MATERIALS AND METHODS: A total of 73 young healthy women, current cigarette smokers and who had never smoked were included. The level of physical activity was assessed using the International Physical Activity Questionnaire; body mass index, circumference measurements, waist-to-hip ratio, skinfold measurements and body fat percentage were used to determine the body composition; HRQOL was assessed through the World Health Organization Quality of Life Instrument; level of depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale; pulmonary functions were evaluated with spirometry. RESULT: We found higher incidence of respiratory symptoms and lower physical activity levels in smokers than those of non-smokers (p< 0.05). There was no significant difference between smokers and non-smokers in respect of HRQOL, depression and anxiety (p> 0.05). In smokers whom cigarette consumption more than 150 p-years, we observed positive correlations between cigarette consumption and arm circumference, waist circumference, waist-to-hip ratio (p< 0.05). CONCLUSIONS: Our results show that the smoking causes an increase in the incidence of respiratory symptoms and reduces the level of physical activity in healthy women. Additionally it leads to abdominal obesity depending on cigarette consumption.

The effect of obesity on dyspnea, exercise capacity, walk work and workload in patients with COPD.

INTRODUCTION: COPD and obesity are major public health problems that cause mortality and morbidity all over the world. The combined of COPD and obesity is predicted to increase further in the coming years. Obesity primarily affects the pulmonary system by altering respiratory functions, exercise capacity, pulmonary gas exchange, and endurance and power of respiratory muscles. In this study, we aimed to compare the dyspnea sensation, exercise capacity, walk work and workload in obese COPD patients compared to preobese and normal overweight COPD patients. MATERIALS AND METHODS: 218 patients with COPD were included in the study. According to the WHO criteria for body mass index (BMI), the patients were classified as normal-weight (BMI=18.5-24.9 kg/m2), pre-obese (BMI= 25-29.9 kg/m2) and obese (BMI= 30-39.9 kg/m2). All patient respiratory function tests and arterial blood gas analysis were performed. The mMRC dyspnea scale was used to assess the dyspnoea of the patients. The exercise capacities of the patients were determined by the 6-min walking test. Walk work and workload were calculated based on 6 minutes walking distance. The obtained values were compared between the three groups. RESULT: The FEV1/FVC ratio and TLCO value in pulmonary function tests are significantly higher in obese COPD patients than in other patients, while the VC value is significantly lower in patients with COPD (p= 0.001, p< 0.001, p= 0.01). Partial carbon dioxidewas significantly higher in obese COPD patients compared to other patients (p= 0.001). Dyspnea perceptions and walking distances did not differ significantly between groups. Walkwork and workload were significantly higher in obese COPD patients (p< 0.001, p= 0.005). CONCLUSIONS: Obesity causes partial changes in blood gas and pulmonary function tests of patients with COPD. At the same time, it increases walkwork and workload. Despite all these changes, it has no negative effect on dyspnea perception and exercise capacity.

Associations of Upper-Extremity Exercise Capacity and Grip Strength With Cognitive Domains in Patients With COPD.

BACKGROUND: Cognitive impairment (CI), which has been reported in COPD, has been related to physical performance. However, the association between CI and upper-extremity functions is unknown. We aimed to compare upper-extremity exercise capacity and grip strength between subjects with COPD with and without CI and to determine the relationship of upper-extremity functions with specific cognitive domains. METHODS: In this cross-sectional study, 76 subjects with COPD (mean age 66.8 ± 7.5 y, FEV1% 47.12 ± 14.10) were classified as with and without CI according to the Montreal Cognitive Assessment. Clinical characteristics, upper-extremity exercise capacity (6-min pegboard ring test [6PBRT]), grip strength (hand dynamometer), dyspnea severity (modified Medical Research Council dyspnea scale), disease-specific health status (COPD Assessment Test), and disease-specific quality of life (St George Respiratory Questionnaire) were compared between groups, and the relationship of upper-extremity functions with cognitive subdomains was analyzed by multivariate regression analysis. RESULTS: The number of 6PBRT rings (P = .01) and the grip strength (P = .033) were lower in subjects with CI. Subjects with CI had lower FEV1% (P = .038), arterial oxygenation (P = .002), exercise habits (P = .033), health status (P = .01), quality of life (P = .042); and higher dyspnea (P < .001), smoking consumption (P = .032), emergency admission (P = .02), and hospitalization (P = .042). The adjusted model showed that executive functions and attention were related to upper-extremity capacity (ß = 14.4 and ß = 10.2, respectively) and hand-grip strength (ß = 1.85 and ß = 1.49, respectively). CONCLUSIONS: These findings suggest that upper-extremity functions might be decreased especially concerning executive functions and attention in subjects with COPD with CI.

Investigation of the psychometric properties of "exercise Benefits/Barriers scale" in Turkish patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic disease accompanied by several symptoms and functional disabilities. Physical activity (PA) is crucial for disease management and patients' perception of exercise is essential for a rehabilitation plan. PURPOSE: This study aims to examine the psychometric properties of the Exercise Benefits/Barriers Scale (EBBS) that is frequently used in previous studies in the RA population. METHODS: We included a total of 104 patients in our study. Test-retest reliability was assessed using intraclass correlation coefficient (ICC 2,k). The International Physical Activity Questionnaire (IPAQ) and the Bristol Rheumatoid Arthritis Fatigue Scale (BRAFS) were used for the convergent validity of the scale. For discriminant validity analysis, the total barriers and benefits scores were examined according to exercise status (yes/no), PA level (high/low), and fatigue severity (high/low). Additionally, standard error of measurement (SEM) and minimal detectable change with 95% confidence (MDC95) are calculated. RESULTS: EBBS subscores showed moderate to excellent reliability (ICC: 0.71 to 0.98) and correlated PA (r = 0.453 and 0.515, EBBS-barriers and benefits subscores, respectively) and fatigue (r=-0.261 and -0.393, EBBS-barriers and benefits subscores, respectively). The SEM and MDC95 values were calculated as 2.03 and 7.96 for EBBS-benefits subscores and 0.93 and 3.65 for EBBS-barriers subscores. The EBBS-Benefits and Barriers subscores differed according to exercise status (p = .08), PA level (p < .01), and fatigue (p = .08). CONCLUSION: The results highlighted that the EBBS is a reliable and valid instrument to assess exercise benefits and barriers in patients with RA.

An investigation of the psychometric properties of the Turkish adaptation of the activity limitations in cerebral palsy questionnaire.

PURPOSE: To translate the ACTIVLIM-CP questionnaire, developed to assess global activity performance in children with Cerebral Palsy (CP), into Turkish and to investigate its psychometric properties. METHODS: Eighty-nine children with CP, aged between 2 and 18 years (mean age: 10.08 ± 4.94 years), were included in the study. Internal consistency was measured by Cronbach's alpha and test-retest reliability was assessed using intraclass correlation coefficient (ICC). Convergent validity was evaluated through the pattern of correlations between the ACTIVLIM-CP with PEDI, ABILOCO-Kids, ABILHAND-Kids, and Wee-FIM scores. Known-group comparisons were made according to epilepsy existence and ambulation level measured by Gross Motor Function Classification System (GMFCS). RESULTS: Internal consistency was excellent (Cronbach's α = 0.990), and the ICC for the test-retest reliability was 0.990. There was a very strong correlation between ACTIVLIM-CP and ABILHAND-Kids (r = 0.946), WeeFIM (r = 0.900), PEDI Functional Skills and Caregiver Assistance scores (r = 0.954, r = 0.937, respectively), and ABILOCO-Kids (r = 0.817) (p < 0.001) score. ACTIVLIM-CP score was lower in children with epilepsy (p = 0.001) and in the high-level group according to GMFCS (p < 0.001). CONCLUSION: The Turkish adaptation of ACTIVLIM-CP is a valid and reliable scale for measuring activity limitations in children with CP and is compatible with other scales evaluating activity limitations. CLINICAL TRIAL NUMBER: NCT05184244IMPLICATIONS FOR REHABILITATIONActivity limitation measurements are crucial and necessary to determine the global activity performance of children with CP.ACTIVLIM-CP was translated and culturally adapted to Turkish and showed good psychometric properties.ACTIVLIM-CP is a valid and reliable tool to evaluate activity performance in children with CP.

Clinimetric properties of the Turkish version of the De-Morton Mobility Index (DEMMI) in intensive care unit survivors - a cross-sectional observational study.

PURPOSE: To investigate the intra-rater reliability and the construct validity of the Turkish version of the De-Morton Mobility Index (DEMMI) in intensive care unit (ICU) survivors. METHODS: Construct validity of the DEMMI was measured by correlating it with physical functioning scales. Known group comparison was made according to the Medical Research Council Sum Score (MRC-SS). Internal consistency was determined by measuring Cronbach α coefficient. Test-retest reliability was assessed by performing the DEMMI by the same researcher after 24 h and calculating the intraclass correlation coefficient (ICC). The minimal detectable change (MDC) value was calculated. RESULTS: One hundred and two patients discharged from the ICU were included. The ICC for intra-reliability was 0.972. The internal consistency was excellent (Cronbach = 0.991). The DEMMI total score was correlated with the Barthel Index (r = 0.791), Katz Index of Independence in Activities of Daily Living (r = 0.722), MRC-SS (0.614), ICU length of stay (r = -0.515), and total mechanical ventilation duration (r = -0.488). The DEMMI was able to differentiate between MRC-SS subgroups (p < 0.001), whereby higher strength was associated with higher DEMMI scores. The MDC was determined to be 6.82 out of 100 points. CONCLUSION: The Turkish version of the DEMMI is reliable and valid for measuring mobility in ICU survivors. TRIAL REGISTRATION NUMBER: NCT05196997Implications for RehabilitationThe Turkish version of the de-Morton Mobility Index (DEMMI) is a reliable and valid outcome measure for the assessment of functional mobility in intensive care unit survivors.The Turkish version of the DEMMI could guide clinicians working in the field of intensive care in the planning of rehabilitation programs after discharge.

A Randomized Cross-Over Analysis of the 6-Minute Step Test When Administered in Different Music Listening Conditions to Healthy Young Adults.

The 6-Minute Step Test (6-MST) is a simple, inexpensive field test that is increasingly used to evaluate cardiorespiratory fitness. Whether sufficient performance is revealed by this test and the effect on it of motivational factors such as music is unknown. In this cross-sectional, randomized, and crossover research design, we aimed to analyze 6-MST performance and test outcomes in different music-related auditory conditions of non-musical/non-rhythmic [NM/NR], musical/non-rhythmic [M/NR], and musical/rhythmic [M/R]). We had 38 healthy young adults (M age = 21.21, SD = 1.21 years; 60% male) complete all tests, and we measured their number of steps taken, heart rate, blood pressure, respiratory rate, peripheral oxygen saturation, perceived dyspnea, and fatigue on the modified Borg scale. We recorded individually calculated submaximal values according to heart rate reached after three tests. The number of steps increased in the M/R condition relative to other conditions (p = 0.003), and the amount of change in perceived leg fatigue was also higher in the M/R condition (p < 0.017). Despite variable test performances in different auditory conditions, we found no statistically significant difference in cardiovascular fitness and symptoms (p > 0.05). We concluded that the 6-MST is a useful tool for assessing maximum cardiac tolerance, especially if administered while listening to rhythmic music.

Investigation of factors associated with static and dynamic balance in early-stage lung cancer survivors.

PURPOSE: Balance impairment and falls are common among patients after cancer treatment. This study aimed to compare static and dynamic balance functions in lung cancer survivors (LCS) and healthy controls and to investigate the factors related to balance in LCS. METHODS: Cross-sectional data were collected from lung cancer patients whose treatment had been completed within the previous 3 months (n = 60) and age and gender-matched healthy controls (n = 60). Clinical characteristics and history of falls were recorded. Pulmonary function tests and measurements of respiratory muscle strength were performed. Dynamic and static balance, fear of falling, knee-extension strength, physical activity level, dyspnea, comorbidity, and quality of life (QoL) were assessed using the Time Up and Go Test, Single Leg Standing Test, the Fall Efficacy Scale-International, hand-held dynamometer, the International Physical Activity Questionnaire, the Modified Medical Research Dyspnea Scale, the Charlson Comorbidity Index, and the European Organization for Research and Treatment of Cancer QoL Scale. RESULTS: LCS reported a higher fall rate and exhibited lower dynamic balance compared to controls (p < 0.05). The number of chemotherapy cycles, number of falls in the past year, fear of falling, perceived dyspnea, forced expiratory volume in 1 s (%), maximal inspiratory pressure (%), knee-extension strength, physical activity score, and QoL score related to physical function were correlated with balance function in LCS (p < 0.05). CONCLUSION: LCS had a higher risk of falls and lower dynamic balance function which might be related to various clinical and physical parameters. IMPLICATIONS FOR CANCER SURVIVORS: Identifying factors related to balance should be considered within the scope of fall prevention approaches for these patients.

Comparison of Self-Efficacy and Problem-Solving Skills Between Women with Asthma and Healthy Controls: A Cross-Sectional Study.

OBJECTIVE: Problem-solving skills and self-efficacy are among the topics that are frequently investigated in people with various chronic conditions. However, there are limited studies on asthma patients. Our study aims to compare self-efficacy and problem-solving skills in asthma patients and healthy controls. MATERIAL AND METHODS: We included 23 women with asthma [age: 39 (34-56) years] and 23 healthy controls [age: 42 (30-55) years] in the study. Participants' sociodemographic and disease-related characteristics, Asthma Control Test, and the Modified Medical Research Council Dyspnea Scale scores were recorded. We examined problem-solving skills with the Problem-Solving Inventory and self-efficacy with General Self-Efficacy Scale. We compared groups with the chi-square test, Mann-Whitney U-test, and Independent Sample t-test. RESULTS: Age, body mass index, educational status, marital status, and occupational status were similar among the groups (P > .05). However, smoking was significantly higher in healthy controls (P < .05). It was found that women with asthma had worse self-efficacy and problem-solving skills compared to healthy controls (P < .05). CONCLUSION: These results showed that there may be problems in socio-cognitive skills associated with the disease. Our study focused on the possibility that female asthma patients may have low levels of self-efficacy and problem-solving skills. Therefore, health professionals designing the rehabilitation program should take these skills into account while conducting the assessment as they may be useful in developing an efficient rehabilitation program.

Comparing Physical Activity and Quality of Life of Caregivers of Children With Physical Disabilities and Typically Developing Children.

There are conflicting reports of the level of physical activity (PA) and its relationship to quality of life (QoL) among caregivers of children with physical disabilities (CwPD). In this cross-sectional study, we aimed to compare the PA levels and QoL of two groups of caregivers - a CwPD group and caregivers of typically developing children (CwTD). We included 32 family caregivers in the CwPD group (22 women, 10 men; M age = 42.1, SD = 6.2 years) and 32 caregivers in the CwTD group (24 women, 8 men; M age = 42.3, SD = 6.1 years). We assessed PA with the International Physical Activity Scale-Short Form (IPAQ-SF) and self-reported activity diaries, and we assessed QoL with the Short-Form 36 (SF-36) questionnaire. Although the IPAQ scores and sitting times of caregivers in these two groups were not statistically different (p > .05), many parameters of self-reported activity diary data and total energy expenditure were significantly higher in the CwPD than the CwTD group (p < .05, effect size = .53-1.10). The CwPD group reported a lower QoL according to the SF-36 and its sub-scores (p < .05, effect size = .54-.77), and higher PA levels than those in the CwTD group. In the CwPD group, moderate, vigorous, and total PA scores were mildly to moderately associated with the total Qol score, and many of its subscores (r = .36 to .60, p < .05). The lower quality of life observed in CwPD, despite high-intensity physical activity levels, suggested that investigators and care providers should consider QoL in the CwPD group to be multifactorial and that here is a need for caregiver interventions to enhance QoL in this underserved population.

Effects of a home-based pulmonary rehabilitation program with and without telecoaching on health-related outcomes in COVID-19 survivors: a randomized controlled clinical study.

OBJECTIVE: To compare the effects of a home-based pulmonary rehabilitation (PR) program with and without telecoaching on health-related outcomes in COVID-19 survivors. METHODS: A total of 42 COVID-19 patients who completed medical treatment were randomly divided into two groups: the study (telecoaching) group (n = 21) and the control (no telecoaching) group (n = 21). Both groups participated in an 8-week home-based PR program including education, breathing exercises, strength training, and regular walking. The study group received phone calls from a physiotherapist once a week. Both groups of patients were assessed before and after the program by means of the following: pulmonary function tests; the modified Medical Research Council dyspnea scale; the six-minute walk test; extremity muscle strength measurement; the Saint George's Respiratory Questionnaire (to assess disease-related quality of life); the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, to assess overall quality of life); and the Hospital Anxiety and Depression Scale. RESULTS: In both groups, there were significant improvements in the following: FVC; the six-minute walk distance; right and left deltoid muscle strength; Saint George's Respiratory Questionnaire activity domain, impact domain, and total scores; and SF-36 social functioning, role-physical, role-emotional, and bodily pain domain scores (p < 0.05). Decreases in daily-life dyspnea, exertional dyspnea, and exertional fatigue were significant in the study group (p < 0.05), and the improvement in SF-36 social functioning domain scores was greater in the study group (p < 0.05). CONCLUSIONS: A home-based PR program with telecoaching increases social functioning and decreases daily-life dyspnea, exertional dyspnea, and exertional fatigue in COVID-19 survivors in comparison with a home-based PR program without telecoaching.

Convergent Validity and Test-Retest Reliability of the Unsupported Upper Limb Exercise Test in Patients with Chronic Neck Pain.

Chronic neck pain (CNP) causes decreased functionality of the upper extremity. A standardized measurement tool is needed for evaluating upper limb capacity in patients with CNP. The unsupported upper-limb exercise test (UULEX) is a simple, inexpensive field test developed to measure peak arm exercise capacity, but there has been no report of its validity and reliability for use with patients with CNP. Our aim in this study was to determine the validity and test-retest reliability of the UULEX for this purpose. In this cross-sectional observational study, 44 patients (33 women, 11 men; M age = 37.7, SD = 13.2 years), performed the UULEX twice, within a 1-week interval for test-retest reliability as measured by the intraclass correlation coefficient (ICC). We correlated the UULEX with the Six Minute Pegboard Ring Test (6PBRT), the 30-second Push-Up Test, and the Disability of Arm, Shoulder, and Hand Questionnaire (DASH) to assess its convergent validity. The UULEX demonstrated excellent test-retest reliability with ICC = 0.97 and 0.95 for test duration and the final weight on board, respectively. We found moderate to strong correlations between the UULEX and the 6PBRT (r = 0.844), the 30-second Push Up Test (r = 0.741) and the DASH (r = -0.639), and all were significant, (p < 0.05). MDC values were determined to be 57.7 seconds for test duration and 0.22 kg for final weight on board. Thus, the UULEX test was valid and reliable for assessing upper extremity functional capacity in patients with CNP.

Static and Dynamic Postural Characteristics in Patients with Chronic Obstructive Pulmonary Disease: The Relationship with Dyspnea and Pulmonary Functions.

BACKGROUND: There is little evidence about posture influence and its relationship with pulmonary functions in chronic obstructive pulmonary diseases(COPD) patients. OBJECTIVES: To compare spinal curvature, mobility, and postural competency in participants with and without COPD and investigate the relationship of postural characteristics with dyspnea and pulmonary functions in COPD patients. METHODS: We included 47 COPD patients and 47 age and gender-matched controls in our cross-sectional study. Participants underwent the following evaluations: modified Medical Research Council Dyspnea Scale, respiratory function test, and postural measurements in the sagittal plane in a standing position using a non-invasive, computer-assisted electromechanical device. Postural variables were compared between groups, and the relationship between postural variables with dyspnea and pulmonary functions was analyzed by multivariate regression analysis. RESULTS: Thoracic and lumbar curvature were higher (p<0.05), thoracic mobility and spinal inclination were lower (p=0.011, p=0.030, respectively) in patients with COPD. Thoracic angle and spinal inclination increased in COPD patients (p=0.040, p=0.011, respectively) while only spinal tilt increased in the control group (p=0.010) under spinal loading. Thoracic angle and mobility were related with dyspnea (r2=0.25, p<0.001), forced expiratory volume in the first second (r2=0.56, p<0.001), forced vital capacity (r2=0.41, p<0.001), and RV (r2 = 0.42, p<0.001). CONCLUSION: COPD patients had greater thoracic and lumbar angles in the static upright posture and lower thoracic mobility and spinal inclination in the sagittal plane. It was observed that patients increase their thoracic angles to maintain postural stability in dynamic conditions. Thoracic angle and mobility were related to dyspnea and pulmonary functions.