ABSTRACT
The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease (COPD) during hospitalization due to an acute exacerbation. This study was a randomized, single-blind clinical trial. Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD (AECOPD) were included in this study. All patients received standard medical and pharmacological care. Patients assigned to the intervention group also received an exercise intervention. The main outcome measures were balance, muscle strength, and exercise capacity. Significant between-group differences were found in muscle strength (p = 0.028) and balance (p = 0.013) after the intervention. All the variables improved significantly (p < 0.05) in the exercise intervention group. In the intervention group, the mean difference in muscle strength between baseline and discharge was 10.47 N. Balance also improved, showing a mean difference of 7.56 seconds on the right leg and 6.57 seconds on the left leg. Exercise capacity improved as well, with a difference of 4.97 stands between baseline and discharge. All the variables showed impairment in the control group. In conclusion, an exercise intervention using a pedal exerciser during the hospital stay of frail elderly patients with an AECOPD improves muscle strength, balance, and exercise capacity.
Subject(s)
Disease Progression , Exercise Therapy , Frail Elderly , Pulmonary Disease, Chronic Obstructive/therapy , Acute Disease , Adrenal Cortex Hormones/therapeutic use , Aged , Aged, 80 and over , Bronchodilator Agents/therapeutic use , Exercise Therapy/instrumentation , Exercise Tolerance , Female , Hospitalization , Humans , Length of Stay , Male , Muscle Strength , Oxygen Inhalation Therapy , Postural Balance , Single-Blind Method , Symptom Flare UpABSTRACT
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).
Subject(s)
Anxiety/prevention & control , Breathing Exercises/methods , Depression/prevention & control , Hospitalization , Pulmonary Disease, Chronic Obstructive/psychology , Aged , Aged, 80 and over , Female , Humans , Male , Pilot Projects , Pulmonary Disease, Chronic Obstructive/therapy , Surveys and QuestionnairesABSTRACT
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Subject(s)
Humans , Echocardiography/methods , /methods , Hypertension, Pulmonary/diagnosis , Chronic Disease , Pulmonary Embolism/diagnosisABSTRACT
BACKGROUND: Nowadays, severe deficiency of vitamin D is not a common finding in most developed countries. However, the prevalence of vitamin D insufficiency is relatively high and it can contribute to the descent of bone mass in osteoporosis risk populations. The objective of our study was to evaluate the prevalence of vitamin D insufficiency in postmenopausal women (PMW), patients with inflammatory bowel disease (IBD) and corticosteroid-dependent asthmatic patients (CAP) and to analyze its relationship with bone mineral density (BMD) and calciotropic hormones. PATIENTS AND METHOD: We studied 299 patients (PMW: 161; IBD: 61; CAP: 77). In all cases, serum levels of PTH and 25OHD were determined and the BMD (DXA, Hologic QDR1000) in lumbar spine (LS) and femoral neck (FN) was measured. RESULTS: Vitamin D insufficiency (25OHD < 15 ng/ml) was observed in 39.1% patients with PMW, 70.7% patients with IBD and 44.2% patients with CAP. 25OHD concentrations were lower in EII patients (p = 0.003) and PTH concentrations were higher in MPM (p < 0.001). We found a negative correlation between PTH and 25OHD in the overall group and this correlation persisted after considering each group separately. After adjusting for remaining variables, 25OHD was found to be significantly associated with BMD at lumbar spine and/or femoral neck in the three groups. CONCLUSIONS: In populations at risk of osteoporosis, there is a high prevalence of vitamin D insufficiency. This insufficiency has a significant effect on bone integrity.
Subject(s)
Bone Density/physiology , Osteoporosis/epidemiology , Vitamin D Deficiency/epidemiology , Adult , Anti-Inflammatory Agents/therapeutic use , Body Mass Index , Female , Humans , Male , Middle Aged , Osteoporosis/drug therapy , Osteoporosis/etiology , Parathyroid Hormone/blood , Postmenopause , Prevalence , Steroids , Vitamin D Deficiency/complicationsABSTRACT
FUNDAMENTO: En la actualidad, la deficiencia grave de vitamina D es infrecuente en la mayoría de los países desarrollados. Sin embargo, la prevalencia del déficit subclínico de vitamina D (insuficiencia de vitamina D [IVD]) es más elevada y puede contribuir al descenso de la masa ósea en poblaciones con riesgo de osteoporosis. El objetivo de nuestro estudio fue evaluar la prevalencia de IVD en mujeres posmenopáusicas (MPM), pacientes diagnosticados de enfermedad inflamatoria intestinal (EII) y pacientes asmáticos en tratamiento con glucocorticoides (PAC) y analizar su relación con la densidad mineral ósea (DMO) y hormonas calciotropas. PACIENTES Y MÉTODO: Estudiamos a 299 sujetos (MPM 161; EII 61; PAC 77). En todos los casos determinamos los valores séricos de hormona paratiroidea (PTH), 25-hidroxivitamina D (25OHD) y la DMO (DXA, Hologic QDR1000) en columna lumbar y cuello femoral. RESULTADOS: La prevalencia de IVD (25OHD < 15 ng/ml) fue del 39,1 per cent en MPM, del 70,7 per cent en la EII y del 44,2 per cent en PAC. La 25OHD fue inferior en el grupo EII (p = 0,003) y la PTH fue superior en el grupo MPM (p < 0,001). Encontramos correlación negativa entre PTH y 25OHD en los 299 sujetos, que también fue significativa al estudiar a cada grupo por separado. Tras ajustar por el resto de las variables, la 25OHD se asoció significativamente a la masa ósea de la columna lumbar y/o el cuello femoral en los tres grupos estudiados. CONCLUSIONES: En poblaciones con riesgo de osteoporosis, el déficit de vitamina D tiene una elevada prevalencia y un efecto significativo en el deterioro de la integridad ósea (AU)