Physical activity levels respiratory and peripheral muscle strength and pulmonary function in young post-COVID-19 patients : A cross-sectional study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) causes permanent problems, even mild severity. The long-term consequences of COVID-19 are still unknown. This study aimed to investigate physical activity levels, respiratory and peripheral muscle strength, and pulmonary function in the long term in young adult COVID-19 patients who recovered from mild disease. METHODS: This cross-sectional study was carried out at least 6 months after the COVID-19 diagnosis, 54 patients with COVID-19 (median age: 20 years) and 46 controls (median age: 21 years) were compared. Functional status (post-COVID-19 functional status scale), respiratory (maximum inspiratory and expiratory pressures (MIP, MEP)) and peripheral muscle strength (dynamometer), pulmonary function (Spirometry), dyspnea and fatigue (modified Borg scale), and physical activity levels (International Physical Activity Questionnaire) were evaluated. CLINICALTRIAL NUMBER: NCT05381714. RESULTS: Patients with COVID-19 measured and percent predicted MIP and MEP were statistically decreased compared with the controls (p < 0.05). Shoulder abductors muscle strength (p < 0.001) and the number of individuals with low physical activity levels were significantly higher in patients compared with controls (p = 0.048). Pulmonary function, quadriceps muscle strength, exertional dyspnea, and fatigue scores were similar in groups (p > 0.05). CONCLUSION: Respiratory and peripheral muscle strength and physical activity levels are adversely affected in patients with COVID-19, even though the patients were mildly affected in the long term. Also, symptoms such as dyspnea and fatigue may persist. Therefore, these parameters should be evaluated in the long term, even in young adults who are mildly affected by COVID-19.

Evaluation of quality of life and physical activity in patients with type 1 diabetes mellitus during the COVID-19 pandemic.

Objective: The aim of the study is to compare the quality of life, physical activity, anxiety, depression, fear of hypoglycemia, loneliness perception in patients with type 1 diabetes mellitus and controls. Subjects and methods: Forty-four patients and 63 controls were included in this cross-sectional study. Quality of life (Short Form 36-SF-36), physical activity level (International Physical Activity Questionnaire-short form), anxiety and depression (Hospital Anxiety and Depression Scale), fear of hypoglycemia (Hypoglycemia Fear Survey), loneliness perception (UCLA Loneliness Scale) were evaluated. Results: Physical role limitations and general health perception subscale scores of SF-36 questionnaire in patients were significantly higher than the controls (p < 0.05). Conclusion: Role limitations due to physical problems and fear of hypoglycemia are increased, and general health perception is impaired in patients with type 1 diabetes mellitus. Physical inactivity is an important symptom in individuals in the pandemic period. In this regard, telerehabilitation approaches will be beneficial for all individuals in increasing physical activity, improving quality of life, and decreasing anxiety, depression and loneliness perception during the pandemic period for all individuals. The importance of a multidisciplinary approach in diabetes management and dealing with problems should be considered in pandemic.

Effects of upper extremity aerobic exercise training on oxygen consumption, exercise capacity, dyspnea and quality of life in patients with pulmonary arterial hypertension.

BACKGROUND: Pulmonary and extrapulmonary impairments are prevalent in pulmonary arterial hypertension (PAH) which is a rare, chronic and progressive disease. OBJECTIVES: To investigate the effects of upper extremity aerobic exercise training on exercise capacity, oxygen consumption, dyspnea and quality of life in patients with PAH. METHODS: In a prospective, randomized controlled, double-blinded study, eleven patients in training group applied upper extremity aerobic exercise training (50-80% of maximal heart rate), 15-45 min/day, 3 days a week for 6 weeks and 11 patients in control group alternating active upper extremity exercises for the same period. Exercise capacity evaluated using six minute walk test (6MWT), oxygen consumption simultaneously measured during 6MWT using a portable instrument, dyspnea modified Borg scale and Modified Medical Research Council dyspnea scale and quality of life Short Form 36 Health Survey, before and after the exercise training. RESULTS: Baseline characteristics of groups were similar (p>0.05). Dyspnea (p<0.001) and peak oxygen consumption (p = 0.031) were significantly improved in training group compared the controls. Dyspnea, exercise capacity, peak oxygen consumption, minute ventilation, tidal volume, end tidal carbon-dioxide pressure, and vitality, social functioning and role-physical were significantly improved within training group (p<0.05). Oxygen consumption at anaerobic threshold were significantly decreased within control group (p<0.05). CONCLUSIONS: Upper extremity aerobic exercise training improves oxygen consumption, and decreases dyspnea perception. It is a safe and effective intervention in patients with PAH. (ClinicalTrials.gov registration: NCT02371733).

Validity and Reliability of the Turkish Version of the London Chest Activity of Daily Living Scale in Obstructive Lung Diseases.

OBJECTIVES: The London Chest Activity of Daily Living Scale (LCADL) is a simple, useful, and comprehensive measure of dyspnea perception in activities of daily living. This study was conducted to determine the validity and reliability of the Turkish version of the LCADL. MATERIALS AND METHODS: A total of 64 patients with obstructive lung disease (24 chronic obstructive pulmonary disease, 20 asthma, and 20 bronchiectasis patients) were included. The Turkish LCADL was evaluated for interobserver reliability, test-retest reliability, and criterion validity. Two different observers applied the scale with an interval of 10 minutes to assess interobserver reliability. The second observer applied the scale twice at an interval of 10-15 days to assess test-retest reliability. Criterion validity was assessed using the 6-minute walk test (6MWT), Nottingham Health Profile (NHP), and Saint George Respiratory Questionnaire (SGRQ). RESULTS: The interobserver reliability of the scale was very high (rs=0.985, p<0.050). Cronbach's alpha coefficient for total score was 0.976 and intraclass correlation coefficient was 0.953. These results indicate that the Turkish LCADL has high reliability. The correlation between LCADL and 6MWT was moderate 0.503 (p=0.002). The LCADL total score was weakly correlated with NHP total score (rs=0.370, p=0.040) and SGRQ total score (rs=0.367, p=0.004). CONCLUSION: The Turkish version of the LCADL scale is reliable and valid in obstructive lung disease. The LCADL scale will be beneficial in existing pulmonary rehabilitation programs aiming to improve functional status. We believe that using the Turkish LCADL scale as an outcome measure in pulmonary rehabilitation programs will serve as an indicator of rehabilitation efficacy for individual patients.

Inspiratory muscle training in allogeneic hematopoietic stem cell transplantation recipients: a randomized controlled trial.

PURPOSE: Respiratory muscles are known to be weakened and are a cause of reduced exercise capacity in both recipients and candidates of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Effects of inspiratory muscle training (IMT) in this patient population have not been comprehensively investigated so far. The current study was planned to investigate the effects of IMT during allo-HSCT on early transplantation-related outcomes. METHODS: This is a prospective, randomized controlled, double-blinded study. Thirty-eight allo-HSCT recipients, 20 of whom were allocated to the treatment group (40 % of maximal inspiratory pressure (MIP)) and 18 to the control group (5 % of MIP), received IMT for 6 weeks. Pulmonary functions, dyspnea, respiratory (MIP, maximal expiratory pressure (MEP)) and peripheral muscle strength, maximal exercise capacity using modified incremental shuttle walking test (MISWT) and submaximal exercise capacity using 6-min walking test (6-MWT), fatigue, depression, and quality of life were evaluated before and after IMT. RESULTS: The distance covered during MISWT (61.94 m) and 6-MWT (29.30 m), respiratory muscle strength (MIP 34.99 cmH2O, MEP 12.69 cmH2O), depression (-0.95), and modified Borg dyspnea scores (-0.11) showed a significant improvement in the treatment group compared to controls (p ≤ 0.05). CONCLUSIONS: Inspiratory muscle training is a safe and effective intervention which improves respiratory muscle strength and exercise capacity and decreases depression and dyspnea in allo-HSCT recipients. These positive changes might be further enhanced by prolonging the duration of training or inclusion of more recipients with inspiratory muscle weakness. CLINICAL TRIAL REGISTRATION NUMBER: NCT02270346.

Relationship between foot sensation and standing balance in patients with multiple sclerosis.

The aims of the present study were to investigate the relationship between the foot sensations and standing balance in patients with Multiple Sclerosis (MS) and find out the sensation, which best predicts balance. Twenty-seven patients with MS (Expanded Disability Status Scale 1-3.5) and 10 healthy volunteers were included. Threshold of light touch-pressure, duration of vibration, and distance of two-point discrimination of the foot sole were assessed. Duration of static one-leg standing balance was measured. Light touch-pressure, vibration, two-point discrimination sensations of the foot sole, and duration of one-leg standing balance were decreased in patients with MS compared with controls (p<0.05). Sensation of the foot sole was related with duration of one-leg standing balance in patients with MS. In the multiple regression analysis conducted in the 27 MS patients, 47.6% of the variance in the duration of one-leg standing balance was explained by two-point discrimination sensation of the heel (R(2)=0.359, p=0.001) and vibration sensation of the first metatarsal head (R(2)=0.118, p=0.029). As the cutaneous receptors sensitivity decreases in the foot sole the standing balance impairs in patients with MS. Two-point discrimination sensation of the heel and vibration sensation of the first metatarsal head region are the best predictors of the static standing balance in patients with MS. Other factors which could be possible to predict balance and effects of sensorial training of foot on balance should be investigated.