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1.
Arch Bronconeumol ; 2024 Jun 18.
Artículo en Inglés, Español | MEDLINE | ID: mdl-39025760

RESUMEN

INTRODUCTION: Pulmonary rehabilitation (PR) is recommended prior to bronchoscopic lung volume reduction (BLVR) procedures to optimize patient outcomes. However, there's a lack of clear guidance on PR content. The aim of our study is to examine the effect of adding inspiratory muscle training (IMT) to standard PR before BLVR on exercise capacity, dyspnea, fatigue level and quality of life. METHODS: Sixty-four patients were randomly assigned to either the PR Group (PRGr) or the PR with IMT group (IMTGr). Both groups underwent an 8-week standard PR program, including breathing exercises, muscle strengthening, and walking. Additionally, IMTGr received IMT sessions. Outcome measures comprised six-minute walking distance (6MWD), maximal inspiratory and expiratory pressures (MIP, MEP), peripheral muscle strength, modified Medical Research Council dyspnea score, fatigue symptom scale, spirometric parameters, Saint George Quality of Life Questionnaire (SGRQ), International Physical Activity Questionnaire Short Form (IPAQ-SF), and Hospital Anxiety and Depression Scale. RESULTS: Our study found no significant difference in exercise capacity improvement between IMTGr and PRGr. However, IMTGr showed significant improvement in MIP compared to PRGr. Both groups experienced improvements in dyspnea, fatigue, and depression scores, as well as enhancements in 6MWD, MEP, peripheral muscle strength, IPAQ-SF and SGRQ scores. CONCLUSION: Adding IMT to PR did not show a significant difference between groups among BLVR-eligible patients. However, improved respiratory muscle strength may have positive clinical implications. Further research is needed to explore short and long-term effects.

2.
Respirology ; 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38981728
3.
Respir Med ; 231: 107724, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38971337

RESUMEN

INTRODUCTION: Very few studies have examined patterns of physical activity (PA) during a pulmonary rehabilitation (PR) program in people with COPD. AIMS: To compare the patterns of PA in: 1) the week before commencing PR (pre-PR) with a week during PR (PR week); 2) PR days and non-PR days during a PR week; 3) pre-PR and the week following PR completion (post-PR). METHODS: This was a multicenter, prospective cohort study. Participants attended twice weekly supervised PR for 8-12 weeks. Daily step count (primary outcome), time in light activities, time in moderate to vigorous PA (MVPA), total sedentary time and sit-to-stand (STS) transitions were measured using a thigh worn accelerometer for seven days, at each assessment time point: pre-PR, PR week and post-PR. RESULTS: 29 participants, mean age (SD) 69years(7), FEV1 53%pred(16). The PR week compared to pre-PR, showed higher daily: step count (mean difference (95%CI)), 941steps(388-1494); and MVPA, 11mins(6-15), with no difference in: time in light activities, -1min(-6-5); total sedentary time, 7mins(-21-36); or STS transitions, 0(-5-6). PR days compared to non-PR days showed higher: step count, 2810steps(1706-3913); time in light activities 11mins(1-20); time in MVPA, 27mins(17-35) and STS transitions, 8(4-12), with no difference in total sedentary time: -33mins(-80-15). There were no differences in any PA measures post-PR compared to pre-PR (p < 0.05). CONCLUSION: Daily step count and time spent in MVPA increased significantly during the PR week, solely due to increased PA on days participants attended PR.

4.
Pak J Med Sci ; 40(6): 1280-1286, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38952505

RESUMEN

Background & Objective: Several studies have investigated the effectiveness of preoperative or perioperative pulmonary rehabilitation in thoracic surgery patients, but the results are inconsistent and inconclusive. This study attempts to summarize the existing data on the effect of the preoperative and perioperative pulmonary rehabilitation nursing program for the management of patients undergoing thoracic surgery. Methods: Systematic search was done in PubMed Central, SCOPUS, EMBASE, MEDLINE, Google Scholar, and ScienceDirect for papers published until December 2022 and reporting data of postoperative complications and pulmonary health status in patients undergoing thoracic surgery and receiving preoperative or perioperative pulmonary rehabilitation nursing intervention or standard care. Meta-analysis was done by random-effects model and pooled standardised mean differences (SMD) or odds ratios (OR) along with 95% confidence intervals (CIs) were reported. Results: Eighteen studies were included and analysed. Pooled SMD was 0.44 (95%CI: -0.21 to 1.08) for forced expiratory volume (FEV-1), -0.34 (95%CI: -0.94 to 0.26) for peak expiratory flow (PEF), 0.61 (95%CI: -0.60 to 1.81) for forced vital capacity (FVC), 0.42 (95%CI: -0.13 to 0.98) for diffusing capacity of carbon monoxide (DLCO). Pooled SMD for length of hospital stay was -0.64 (95%CI: -1.09 to -0.19). Pooled OR was 0.87 [95%CI: 0.32 to 2.37] for all-cause mortality, 0.35 [95%CI: 0.25 to 0.50] for postoperative pulmonary complications, 0.98 [95%CI: 0.45 to 2.12] for respiratory failure, 0.52 [95%CI: 0.38 to 0.78] for pneumonia and 0.50 [95%CI: 0.33 to 0.76] for atelectasis. Conclusion: Perioperative pulmonary rehabilitation nursing program is effective in reducing the postoperative lung complications and shortening the length of hospital stay in patients undergoing thoracic surgery.

5.
Int J Chron Obstruct Pulmon Dis ; 19: 1579-1589, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38983577

RESUMEN

Purpose: Pulmonary rehabilitation (PR) is a type of multidisciplinary care strongly recommended after severe exacerbation of chronic obstructive pulmonary disease (COPD). Recently, a national French study reported a very low rate of PR uptake (8.6%); however, important clinical data were missing. Here, we aimed to identify the main factors associated with insufficient PR uptake after hospitalisation for COPD exacerbation. Patients and Methods: This multicentre retrospective study included patients hospitalised with COPD exacerbation between 1 January 2017 and 31 December 2018, as identified by both coding and a detailed review of medical records. PR was defined as inpatient care in a specialised centre or unit within 90 days of discharge. Multivariate logistic regression was used to identify associations between PR uptake and patient characteristics, such as comorbidities, non-invasive ventilation (NIV), inhaled treatment, and forced expiratory volume in 1 second (FEV1). Results: Among the 325 patients admitted for severe COPD exacerbation, 92 (28.3%) underwent PR within 90 days of discharge. In univariate analysis, relative to those who underwent PR, patients without PR had significantly more comorbidities, were less often treated with triple bronchodilator therapy or NIV, and had a higher FEV1. In multivariate analysis, variables independently associated with the lack of PR uptake were the presence of comorbidities (adjusted odds ratio (aOR) = 1.28 [1.10-1.53], p = 0.003) and a higher FEV1 (aOR = 1.04 [1.02-1.06], p < 0.001). There was no significant correlation between PR uptake and departmental PR centre capacity (notably, some departments had no PR facilities). Conclusion: These data highlight the lack of PR in the early stages of COPD. Collaboration among all healthcare providers involved in patient management is crucial for improved PR uptake.


Pulmonary rehabilitation (PR) is multidisciplinary care strongly recommended after severe exacerbation of chronic obstructive pulmonary disease (COPD); however, referral remains very low in France. We have shown, in three French centres, that early-stage COPD and associated comorbidities are the main factors contributing to insufficient PR after hospitalisation for exacerbation. Collaboration among all healthcare providers involved in patient management is crucial to improve PR uptake in the years ahead because physical medicine and rehabilitation professionals play key roles in the promotion and early initiation of PR programs.


Asunto(s)
Progresión de la Enfermedad , Enfermedad Pulmonar Obstructiva Crónica , Índice de Severidad de la Enfermedad , Humanos , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Masculino , Estudios Retrospectivos , Femenino , Anciano , Francia/epidemiología , Persona de Mediana Edad , Factores de Tiempo , Volumen Espiratorio Forzado , Pulmón/fisiopatología , Resultado del Tratamiento , Factores de Riesgo , Ventilación no Invasiva/estadística & datos numéricos , Broncodilatadores/uso terapéutico , Comorbilidad , Anciano de 80 o más Años , Recuperación de la Función
6.
Respir Med ; : 107740, 2024 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-39009098

RESUMEN

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a leading cause of death, and cardiovascular (CV) comorbidities play a role. Evidence of the pulmonary rehabilitation (PR) effect in reducing the CV risk (CVR) in COPD patients is limited. In this study, we aimed to determine the impact of an 8-week PR program (PRP) on the CVR of the overall population and to compare the impact on the exacerbator versus non-exacerbator patients. PATIENTS AND METHODS: This was a prospective study that included adults who had post-bronchodilator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) (FEV1/FVC) ratio <70% and FEV1 <80% predicted, had quit smoking for at least 1 year and had a history of tobacco consumption greater than 10 packs/year, and were clinically stable in the last 8 weeks. Pre- and post-PRP assessments included respiratory function evaluation, laboratory tests, and exercise capacity assessment (6-minute walking test [6MWT]). CVR was assessed using different risk prediction models. RESULTS: A total of 50 patients (28 exacerbators and 22 non-exacerbators) completed the PRP (median age: 64.5 years, men: 72%; arterial hypertension: 70%, dyslipidemia: 30%, diabetes: 20%; CV disease (CVD): 24%. After the PRP, exacerbator patients showed a significant decrease in the CVR calculated by the COPDCoRi model (p<0.001); patients with ≥30-meter increase on the 6MWT showed statistically significant lower levels of glucose (p=0.004), HbA1c (p=0.004) and BODE index score (p=0.026) compared to patients with <30-meter increase. CONCLUSIONS: PR reduced certain modifiable CVR factors and CVD risk, especially in exacerbator patients.

7.
Pol Merkur Lekarski ; 52(3): 292-299, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39007467

RESUMEN

OBJECTIVE: Aim: The aim of the study is todetermine the feasibility of using a home pulmonary rehabilitation program and evaluate its impact on patients with COPD in the GOLD B group. PATIENTS AND METHODS: Materials and Methods: The study was conducted on the basis of the «Healthy Movements¼ studio (Poltava). Patients were involved in the study after receiving secondary (specialized) medical care, the basis of which was physical therapy treatment and exercise therapy in accordance with the clinical protocol approved by the internal order of the health care institution. A total of 30 people (aged 59 to 68.4 years) with II degree chronic obstructive pulmonary disease (50 % ≤ FEV1 < 80 % of normal) in remission took part in the study. Research methods: pedagogical, medical and biological , methods of mathematical statistics. RESULTS: Results: Each patient confirmed the achievement of the general goal, namely, increasing the number of therapeutic exercises from 3 to 5 times a week, improving the quality of life, more active participation in improving their health and awareness of the disease. The patients considered self-management training to be the most valuable. CONCLUSION: Conclusions: Pulmonary rehabilitation is indicated for all patients, regardless of the degree of the disease. The most ef f ective are 6-12 week programs that include breathing exercises, self-management training and training of the patient's environment, strengthening exercises, psychological support, diet therapy.


Asunto(s)
Terapia por Ejercicio , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Enfermedad Pulmonar Obstructiva Crónica/terapia , Persona de Mediana Edad , Masculino , Anciano , Femenino , Calidad de Vida , Modalidades de Fisioterapia , Resultado del Tratamiento
8.
Respir Med ; 231: 107728, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38969025

RESUMEN

BACKGROUND: Although the benefits of pulmonary rehabilitation (PR) in the management of chronic respiratory disease conditions (CRC) are well-documented, it remains underutilized. In Jordan, the scarcity of PR services denies those with CRC the opportunity to improve their functional capacity, mental health, and quality of life. OBJECTIVE: To explore the factors related to the implementation of PR in Jordan from the perspective of the healthcare professionals (HCPs). METHODS: This was a qualitative study that utilized semi-structured interviews informed by the Theoretical Domains Framework (TDF). Twenty-one HCPs were interviewed. Interview transcripts were coded against the relevant TDF domain(s) and then domains' summaries were generated. RESULTS: A total of 997 quotes were coded against the TDF domains. Knowledge, environmental context and resources, social influences, and skills domains were the ones most coded. The study identified several barriers to PR implementation such as: limited knowledge and skills pertaining to PR among HCPs, limited public awareness of PR, financial costs, limited legislation related to establishment of PR and role confusion of HCPs in PR. The main facilitators include: HCPs willingness to be involved in new programs such as PR, the perception of the importance and need for PR and HCPs beliefs about capabilities to overcome barriers for a successful implementation of PR. CONCLUSION: The current study provided information that will inform stakeholders and policymakers about the factors affecting PR implementation in Jordan. Improvements in HCPs skills and knowledge about PR, financial support, improvements in undergraduate syllabi and policies to control PR service provision are considered to be key to a successful implementation of PR.

9.
Respirology ; 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-39009414
10.
Trials ; 25(1): 487, 2024 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-39020430

RESUMEN

BACKGROUND: Pulmonary rehabilitation (PR) is accepted as standard care for individuals with COPD. We conducted an international, multi-centred randomized controlled trial (RCT) to determine if adding balance training to PR would reduce the incidence of falls in people with COPD. While there have been many trials investigating the effectiveness of PR, few have involved international collaboration. Successful execution of rehabilitation trials requires a significant investment of time, staffing, and resources. With the recent completion of the Balance Training for Fall Reduction in COPD RCT, we report on the design, implementation, and execution of our trial using project management phases. We also highlight our lessons learned for consideration in future multi-centre rehabilitation trials. METHODS: This was a retrospective review of the planning, preparation, timelines, and personnel training involved in the execution of this study using four of the five project management phases described by Farrell et al. in 2010: (1) initiation, (2) planning, (3) execution, and (4) monitoring and controlling. We report descriptive statistics as percentages and counts and summarize our lessons learned. RESULTS: Ten outpatient PR programs in three continents participated. Thirty-one personnel worked on the trial across all sites. Enrolment began in January 2017 and was suspended in March 2020 due to the COVID-19 pandemic. Approximately 1275 patients were screened, 455 (36%) were eligible, 258 (57%) consented, 243 (53%) participated, and 130 (61%) completed the 12-month follow-up assessment. Lessons learned through our experience included (1) ensuring awareness of funder policies and considering the impact on collaborating sites; (2) preparing for the possibility of human resource and program disruptions; (3) anticipating site dropout and having a contingency plan in place; (4) planning and monitoring process measure data before, during, and after trial initiation; (5) ensuring frequent and consistent communication with and between collaborating sites; (6) maximizing features of database platform to ensure data set completeness and controlled data access; and (7) identifying strategies for increasing patient engagement in a high-demand study. CONCLUSIONS: We identify seven lessons learned through our experience conducting an international, multicentre rehabilitation-based RCT. These lessons can provide guidance to other trialists conducting studies with similar logistics and may assist with future trial planning and implementation.


Asunto(s)
Accidentes por Caídas , Equilibrio Postural , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Accidentes por Caídas/prevención & control , Estudios Retrospectivos , Incidencia , Resultado del Tratamiento , Estudios Multicéntricos como Asunto , Proyectos de Investigación , Ensayos Clínicos Controlados Aleatorios como Asunto , Terapia por Ejercicio/métodos , Factores de Tiempo
11.
Respir Med Case Rep ; 51: 102078, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39027817

RESUMEN

Idiopathic pleuroparenchymal fibroelastosis (iPPFE) is a rare form of idiopathic interstitial pneumonia. We report a case of a patient with iPPFE in whom postural changes improved diaphragmatic excursion (DE) and exercise tolerance. Chest radiography showed a greater elevation of the diaphragm at maximum expiration in the supine position than the standing position. DE measured by ultrasonography was higher in the supine position than the standing position. The findings may suggest greater diaphragm movement in the supine position, leading to successful rehabilitation and improved exercise endurance. There is no effective treatment for iPPFE; therefore, an innovative treatment strategy is warranted.

12.
J Family Med Prim Care ; 13(6): 2237-2241, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39027852

RESUMEN

Objective: To determine the effectiveness of the telemedicine-based pulmonary rehabilitation programme in COVID-19 pneumonitis. Design: Prospective intervention study. Setting: Rehabilitation outpatient department, Tertiary-Care institute. Participants: Consecutive sample of patients (N = 50) in recovered COVID-19 infection. Intervention: Six weeks of telemedicine-based pulmonary rehabilitation in recovered patients of COVID-19 infection. Outcome Measures: All patients were clinically assessed by six minutes walk test (6MWT), Modified Medical Research Council Scale (mMRC), 30s-STS and SF 36 at zero week and six weeks post-intervention. Statistical Analysis: Difference in means of pre- and post-intervention was compared using paired t-test. A P value <0.05 was considered statistically significant. Results: The 6MWT, mMRC Scale, 30 seconds sit-to-stand test, and WHO QoL scale-SF 36 were assessed and post-rehabilitation sessions, all the patients' showed improvement in the prescribed parameters. After six weeks of respiratory rehabilitation, the distance covered in the 6MWT was significantly longer than that of before the intervention. There was a significant difference between zero and six weeks during the PR intervention. mMRC and 30s-STS results showed a significant difference between zero and six weeks (2.36 ± 0.598, 4.54 ± 1.94. Quality of life improved significantly after six weeks of pulmonary rehabilitation in eight domains of the SF-36. Conclusion: Six-week pulmonary rehabilitation programme delivered through telemedicine platform improves respiratory function, QoL and anxiety in patients with post-COVID-19 pneumonia during a recovery phase.

13.
Eur J Oncol Nurs ; 71: 102655, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38968668

RESUMEN

PURPOSE: The absence of standardized protocols and education are the main obstacles to perioperative pulmonary rehabilitation (PR), especially for patients with high-risk factors of postoperative pulmonary complications (PPCs). We aimed to explore the effect of a hybrid structured pulmonary rehabilitation education program (SPREP) on patients with lung cancer at high risk of PPCs. METHODS: A quasi-experimental trial with a pre-post test design was conducted. The control group (n = 53) adopted routine perioperative pulmonary rehabilitation, while the intervention group (n = 53) received SPREP. Respiratory function, 6-min walk distance, Borg dyspnea scale, quality of life, anxiety-depression scores at admission, discharge, 2 weeks and 3 months post-discharge, and incidence of PPCs were compared between the two groups. RESULTS: There were no significant differences on the 6-min walk distance and Borg Dyspnoea Scale at discharge between the two groups (P > 0.05), whereas the intervention group showed improved performance at the remaining time points (P < 0.05). In addition, the intervention group had improved exercise capacity, pulmonary function and quality of life, reduced levels of anxiety and depression at discharge, 2 weeks post-discharge and 3 months post-discharge (P < 0.05). In addition, incidence of PPCs was significantly reduced in the intervention group, especially postoperative pneumonia. CONCLUSIONS: The SPREP could show significant benefits in enhancing exercise capacity, lung function, and quality of life, while diminishing the occurrence of PPCs and mitigating the levels of anxiety and depression, future large RCT need to further explore the efficacy. TRIAL REGISTRATION: This study was registered with the China Clinical Trial Registration Center (ChiCTR) under the Clinical Trial Registration Number [ChiCTR2200066698].

15.
Technol Health Care ; 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38848200

RESUMEN

BACKGROUND: Patients who have been treated with mechanical ventilation for more than 72 hours are susceptible to symptoms such as hypoxia and respiratory muscle fatigue after weaning, which may result in weaning difficulty and delay, as well as an increased incidence of negative emotions such as anxiety and depression. Correct pulmonary rehabilitation exercise technique and timing can improve the weaning success rate, reduce the disability rate, and reduce the incidence of pulmonary infection, as well as reduce medical expenses. OBJECTIVE: This article provides a review of pulmonary rehabilitation interventions for mechanically ventilated patients, searching relevant literature through databases such as CNKI and PubMed, aiming to provide guidance for the successful weaning of mechanically ventilated patients. METHODS: We selected articles related to pulmonary rehabilitation interventions for mechanically ventilated patients from CNKI (China National Knowledge Infrastructure) and PubMed over the years. RESULTS: This article provides a comprehensive review of the research on lung rehabilitation for patients who are mechanically ventilated during the weaning process in an effort to serve as a guide for a successful transition from mechanical ventilation. CONCLUSION: Early pulmonary rehabilitation training can effectively increase the pulmonary function level and ventilation function of patients and reduce the duration of mechanical ventilation and hospitalization, and is an effective, safe, and feasible treatment method.

16.
J Bodyw Mov Ther ; 39: 558-564, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38876685

RESUMEN

BACKGROUND: Patient education is an effective tool in enhancing compliance and comprehension to therapy. Preoperative video-based education (VBE) on knowledge and understanding of surgical procedures and physical therapy provides an insight into the essential need for treatment adherence and early post-operative recovery. Self-efficacy (SE) is an individual self-belief about one's ability to cope and is denoted as a sign of healthy behavior and empowerment. Although little is known about VBE and self-efficacy (SE) in rehabilitation of pulmonary surgery patients. The objective was to assess the influence of VBE in pulmonary rehabilitation on SE post pulmonary surgery patients using the Manipal Self Efficacy Questionnaire (MSEQ). METHODS: Study design: Mixed methods pilot study. The MSEQ and educational video were designed and developed for this study. Piloting was conducted with the MSEQ (CVI = 0.95) and educational video (CVI = 1). After approval from the ethics committee, written informed consent was obtained from twenty preoperative pulmonary surgery patients were randomized to two groups. The control group (n = 30) received routine post-operative exercises and experimental group (n = 30) received preoperative VBE along with exercises. RESULTS: Validation of MSEQ and educational video was derived as per content validation index. Mann- Whitney U test and Wilcoxon signed rank test were used to compare the groups. SE scores in the experimental group was higher than the control (p = 0.004). DISCUSSION AND CONCLUSION: VBE on PR improved SE of the patients after pulmonary surgery. The study's main limitation was the difficulty in attaining the desired sample size because it was a time-bound study.


Asunto(s)
Educación del Paciente como Asunto , Autoeficacia , Humanos , Femenino , Masculino , Educación del Paciente como Asunto/métodos , Persona de Mediana Edad , Proyectos Piloto , Adulto , Anciano , Pulmón/cirugía
17.
Chron Respir Dis ; 21: 14799731241264789, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38901833

RESUMEN

Background: Previous studies have focused on demographic factors that might predict non-completion of pulmonary rehabilitation (PR). We aimed to identify key modifiable factors that promote completion of PR. Methods: A mixed methods survey was offered to participants completing a discharge assessment following PR. Descriptive statistics and inductive thematic analysis were used to analyse the survey responses, with investigator triangulation. Results: 62 of 187 (33%) patients attending a PR discharge assessment between November 2022 and April 2023 returned the anonymised survey. Desire to improve health and wellbeing was the main reason for both initially committing to a course and for continuing with PR past transient thoughts of leaving. The positive impact of staff was the second most common reason. The enjoyment of the PR programme, being held accountable to attend classes, and the importance of other group members were other key themes identified. Conclusions: In conclusion, our findings suggest PR services need to implement strategies which ensure regular promotion and reinforcement of the health benefits of PR as well as implementation of PR modalities which best monopolise on the positive impact skilled staff have on motivating patients to complete PR.


Asunto(s)
Motivación , Investigación Cualitativa , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Encuestas y Cuestionarios , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Enfermedad Pulmonar Obstructiva Crónica/psicología , Cooperación del Paciente/psicología
18.
Complement Ther Clin Pract ; 57: 101867, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38901395

RESUMEN

BACKGROUND: Healthcare providers have faced challenges for patients with moderate and severe chronic obstructive pulmonary disease (COPD) in conducting their pulmonary rehabilitation due to dyspnea and exercise intolerance. Neuromuscular electrical stimulation (NMES) has been used to improve the muscle group's power and endurance without adding pulmonary workload, which might be used as a potential adjuvant rehabilitation method and thus to improve patients' pulmonary functions. METHODS: This was a systematic review and meta-analysis of randomized controlled trials. Data were retrieved from PubMed, CINAHL, Academic Search Complete, Cochrane Library, and Airiti Library databases from the inception of the database to December 2022. The Cochrane Collaboration tool was used to assess the risk of bias. Two reviewers independently assessed, extracted, and appraised the included studies. Then, the grading of recommendations, assessment, development, and evaluation (GRADE) methodology was used for assessing the certainty of evidence. The pooled estimates were calculated using a random-effects model. RESULTS: In total, 19 studies involving 589 moderate to severe COPD patients were analyzed. Compared with controls, adding NMES to pulmonary rehabilitation could significantly increase exercise capacity, physical activity function, and health-related quality of life (HRQoL) (all p < 0.05). The GRADE results showed low to very low certainty of evidence levels. CONCLUSION: NMES could improve exercise capacity and reduce the perceived sensation of dyspnea during exercise and is recommended as an effective adjuvant training modality in the rehabilitation for moderate to severe COPD patients.

19.
Respir Res ; 25(1): 248, 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38890699

RESUMEN

BACKGROUND: The term "post-COVID-19 condition" refers to the symptomatology that appears between four to twelve weeks after Covid-19 infection. These symptoms can persist for weeks or even months, significantly diminishing the quality of life for affected individuals. The primary objective of this study was to assess the effectiveness of pulmonary rehabilitation programs and/or respiratory muscle training on respiratory sequelae in patients with post-COVID condition. METHODS: The literature search was conducted in the following databases: PubMed, PEDro, Embase, Cochrane, Scopus, and Web of Science. Randomized clinical trials were included in which participants were aged 18 years or older. Articles were excluded if at least one of the therapies did not involve pulmonary rehabilitation or respiratory muscle training, if the participants were COVID positive, if studies lacked results, and finally, if interventions were conducted without supervision or at home. This review only encompasses supervised non-virtual interventions. This study adheres to the PRISMA statement and has been registered in the PROSPERO database (CRD42023433843). RESULTS: The outcomes obtained in the included studies are assessed across the following variables: Exercise capacity using the 6-minute walk test, Dyspnea, fatigue, Pulmonary function, Maximum inspiratory pressure, and Quality of life. CONCLUSION: Despite the absence of a specific treatment at present, it was evident from this review that a well-structured pulmonary rehabilitation program that incorporates both aerobic and muscular strength exercises along with techniques and inspiratory muscle exercises was the most effective form of treatment.


Asunto(s)
Ejercicios Respiratorios , COVID-19 , Humanos , COVID-19/rehabilitación , Ejercicios Respiratorios/métodos , Resultado del Tratamiento , Músculos Respiratorios/fisiopatología , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Tolerancia al Ejercicio/fisiología , Síndrome Post Agudo de COVID-19
20.
F1000Res ; 13: 405, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38895701

RESUMEN

Objectives: Interstitial Lung Disease (ILD) is a severe and rapidly progressing disease with a high fatality rate. Patient education (PE) has been demonstrated to promote long-term adherence to exercise and lifestyle improvements by assisting patients in developing self-management techniques. Our scoping review's goal was to chart out the prevailing level of research about the content, processes, and effectiveness of PE for patients with ILD. Methods: The relevant databases were searched using the rules provided by Arksey and O'Malley in 2005 and the Joanna Briggs Institute reviewers' manual 2015: an approach for JBI scoping reviews. Individuals with ILD, published in English between the years of inception and 2020, and describing PE administered by various healthcare practitioners were among the 355 studies found and reviewed. Thirteen studies met these criteria. Results: PE delivery process, delivery techniques, quality of life assessments, common PE themes, and healthcare professional participation were all recognized and cataloged. Conclusion: Despite the fact that healthcare professionals (physicians, nurses, and physiotherapists) provide PE to patients with ILD regularly, the PE provided varies greatly (contents of PE, process of delivery and delivery techniques). During the scoping review, a significant variation in the themes was addressed. They could not provide any evidence-based specific recommendations for all healthcare practitioners due to the studies' heterogeneity and lack of effectiveness measures.


Asunto(s)
Enfermedades Pulmonares Intersticiales , Educación del Paciente como Asunto , Enfermedades Pulmonares Intersticiales/terapia , Humanos , Calidad de Vida
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