Reply to Yigit, S.; Akinci, B. Comment on "Vázquez-Gandullo et al. Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 5564".

We would like to thank you for your interest [...].

Exercise Capacity and Physical Activity in Non-Cystic Fibrosis Bronchiectasis after a Pulmonary Rehabilitation Home-Based Programme: A Randomised Controlled Trial.

BACKGROUND: Patients with chronic respiratory disease have low exercise capacity and limited physical activity (PA), which is associated with worsening dyspnoea, exacerbations, and quality of life. The literature regarding patients with non-cystic fibrosis bronchiectasis (non-CF BQ) is scarce, especially regarding the use of cardiopulmonary exercise tests (CPET) to assess the effects of home-based pulmonary rehabilitation programmes (HPRP). The aim was to evaluate the effect of an HPRP on the exercise capacity of non-CF BQ patients using CPET and PA using an accelerometer. METHODS: Our study describes a non-pharmacological clinical trial in non-CF BQ patients at the Virgen Macarena University Hospital (Seville, Spain). The patients were randomised into two groups: a control group (CG), which received general advice on PA and educational measures, and the intervention group (IG), which received a specific 8-week HPRP with two hospital sessions. The variables included were those collected in the CPET, the accelerometer, and others such as a 6 min walking test (6MWT) and dyspnoea. The data were collected at baseline and at an 8-week follow-up. RESULTS: After the intervention, there was a significant increase in peak VO2 in the IG, which was not evidenced in the GC (IG 66.8 ± 15.5 mL/min p = 0.001 vs. CG 62.2 ± 14.14 mL/min, p = 0.30). As well, dyspnoea according to the mMRC (modified Medical Research Council), improved significantly in IG (2.19 ± 0.57 to 1.72 ± 0.05, p = 0.047) vs. CG (2.07 ± 0.7 to 2.13 ± 0.64, p = 0.36). In addition, differences between the groups in walked distance (IG 451.19 ± 67.99 m, p = 0.001 vs. CG 433.13 ± 75.88 m, p = 0.981) and in physical activity (IG 6591 ± 3482 steps, p = 0.007 vs. CG 4824 ± 3113 steps, p = 0.943) were found. CONCLUSION: Participation in a specific HPRP improves exercise capacity, dyspnoea, walked distance, and PA in non-CF BQ patients.

Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review.

Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD reveal the importance of respiratory rehabilitation (RR) and its role in improving symptoms, quality of life, and psychosocial sphere of patients. Within RR, the inspiratory muscle training (IMT) has received special interest, showing benefits in maximum inspiratory pressure, perception of well-being, and health status in patients with chronic heart disease, respiratory diseases, and dyspnea during exercise. The aim of this review is to assess the efficacy of IMT in COPD patients through the use of inspiratory muscle training devices, compared with respiratory rehabilitation programs without inspiratory muscle training. In the last years, many mechanical devices focused on inspiratory muscle training have been developed, some of them, such as the AirOFit PRO™, PowerBreath®, or FeelBreathe®, have shown clear benefits. The active search for candidate patients to undergo the RR program with inspiratory muscle training using this type of device in COPD patients represents an advance in the treatment of this disease, with direct benefits on the quality of life of the patients. In this article, we review the available evidence on IMT in these patients and describe the different devices used for it.

Chronic Effects of a Training Program Using a Nasal Inspiratory Restriction Device on Elite Cyclists.

This study compared the response of a 9-week cycling training on ventilatory efficiency under two conditions: (i) Combined with respiratory muscle training (RMT) using a new nasal restriction device (FeelBreathe) (FB group) and (ii) without RMT (Control group). Eighteen healthy elite cyclists were randomly separated into the FB group (n = 10) or Control group (n = 8). Gas exchange was measured breath by breath to measure ventilatory efficiency during an incremental test on a cycloergometer before (Pre) and after (Post) the nine weeks of training. The FB group showed higher peak power (Δ (95%HDI) (0.82 W/kg (0.49, 1.17)), VO2max (5.27 mL/kg/min (0.69, 10.83)) and VT1 (29.3 W (1.8, 56.7)) compared to Control at PostFINAL. The FB group showed lower values from Pre to PostPRE in minute ventilation (VE) (-21.0 L/min (-29.7, -11.5)), Breathing frequency (BF) (-5.1 breaths/min (-9.4, -0.9)), carbon dioxide output (VCO2) (-0.5 L/min (-0.7, -0.2)), respiratory equivalents for oxygen (EqO2) (-0.8 L/min (-2.4, 0.8)), heart rate (HR) (-5.9 beats/min (-9.2, -2.5)),, respiratory exchange ratio (RER) (-0.1 (-0.1, -0.0) and a higher value in inspiratory time (Tin) (0.05 s (0.00, 0.10)), expiratory time (Tex) (0.11 s (0.05, 0.17)) and end-tidal partial pressure of CO2 (PETCO2) (0.3 mmHg (0.1, 0.6)). In conclusion, RMT using FB seems to be a new and easy alternative ergogenic tool which can be used at the same time as day-to-day training for performance enhancement.

Fumadora con múltiples recaídas / Smokers with multiple relapses

No disponible

Definición y epidemiología de la enfermedad tromboembólica venosa / No disponible

No disponible

El porqué de la GesEPOC en nuestro entorno / The Rationale for GesEPOC in Our Environmen

No disponible

Oxigenoterapia domiciliaria en la hipertensión pulmonar y patologias no respiratorias autores / No disponible

No disponible

El infradiagnóstico de la enfermedad pulmonar obstructiva crónica en mujeres. ¿Otra tarea pendiente? / The Underdiagnosis of Chronic Obstructive Pulmonary Disease in Women. Another Pending Task?

No disponible

Impacto de las agudizaciones e ingresos en la EPOC / Impact of exacerbations and admissions in chronic obstructive pulmonary disease

En la historia natural de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) hay períodos deincremento de los síntomas, que conocemos como agudizaciones de la EPOC (AEPOC), que en ocasiones precisande ingreso hospitalario. Aunque todavía hay debate en cuanto a su definición, y ello ha generado unafalta de homogenidad en los múltiples estudios realizados, estas agudizaciones repercuten de manera muynegativa en los pacientes, y producen un deterioro clínico y de la función pulmonar a largo plazo. Tambiénconllevan una disminución de la calidad de vida, que se ve afectada a medio y largo plazo, y un coste sociosanitarioelevado, especialmente durante los ingresos hospitalarios. Finalmente, las AEPOC incrementan la mortalidadde los pacientes tanto a corto plazo, durante el ingreso hospitalario, como después de la hospitalización.Por todo lo anterior, prevenir las AEPOC se ha convertido en uno de los objetivos fundamentales en estospacientes(AU)

During the natural history of patients with chronic obstructive pulmonary disease (COPD), an increase insymptom severity can occur, called exacerbated COPD (ECOPD), sometimes requiring hospital admission.Although there is ongoing debate on the definition of ECOPD –leading to a lack of homogeneity in thenumerous studies performed– exacerbations negatively affect patients, producing clinical and pulmonaryfunction deterioration in the long term. Exacerbations also decrease quality of life in the medium- andlong-term and have a high social and health cost, especially during hospital admission. Finally, ECOPDincreases mortality in patients in the short-term, during hospital admission, and after discharge. In view of allof the above, prevention of ECOPD has become one of the main objectives in these patients(AU)

[Impact of exacerbations and admissions in chronic obstructive pulmonary disease]. / Impacto de las agudizaciones e ingresos en la EPOC.

During the natural history of patients with chronic obstructive pulmonary disease (COPD), an increase in symptom severity can occur, called exacerbated COPD (ECOPD), sometimes requiring hospital admission. Although there is ongoing debate on the definition of ECOPD--leading to a lack of homogeneity in the numerous studies performed--exacerbations negatively affect patients, producing clinical and pulmonary function deterioration in the long term. Exacerbations also decrease quality of life in the medium- and long-term and have a high social and health cost, especially during hospital admission. Finally, ECOPD increases mortality in patients in the short-term, during hospital admission, and after discharge. In view of all of the above, prevention of ECOPD has become one of the main objectives in these patients.

[Annual Review of COPD]. / Revista del año de la EPOC.

There have been significant advances in the knowledge in the thoracic and extrathoracic aspects of chronic obstructive pulmonary disease (COPD) in the past few years. COPD is associated with numerous comorbidities, the prevalences of which have recently been evaluated. Dyspnea has been shown to be associated with neuropsychiatric disturbances, such as anxiety. Muscular dysfunction has been associated with inflammation and oxidative stress, in which respiratory muscle satellite cells play an important role in repair. Respiratory rehabilitation and physiotherapy must form an important part of individualised patient treatment analogous to the pharmacological treatment. As regards acute exacerbations, infection is the cause of 75% of them, sputum characteristics and the suspicion of Pseudomonad being key factors in the antibiotic treatment. Questions, such as markers which can detect the origin of the infection, prognostic factors, or the role of short stay pneumology units, are of particular importance. The variability in COPD treatments and the lack of suitable international clinical guidelines, continue to be subjects of debate. To the poor use of the treatment schemes in the guidelines, can be added the irregular uses of inhaled medication, the insufficient use of medical advice or the low intervention in cigarette smoking in all age groups.

Revista del año de la EPOC / Annual Review of COPD

Durante los últimos años se han producido importantes avances en el conocimiento de la enfermedad pulmonarobstructiva crónica (EPOC), tanto en aspectos torácicos como extratorácicos. La EPOC se asocia anumerosas comorbilidades, incluidas el cáncer broncogénico, cuyas prevalencias se han evaluado. La disneaha demostrado estar relacionada con las alteraciones neuropsiquiátricas como la ansiedad. La disfunciónmuscular se ha relacionado con la inflamación y el estrés oxidativo, en cuya reparación tienen un papelrelevante las células satélite del músculo respiratorio. La rehabilitación respiratoria y la fisioterapiadeben formar parte de un tratamiento individualizado del paciente de manera análoga al tratamiento farmacológico.Sobre las agudizaciones, la infección es causa del 75% de éstas; las características del esputo yla sospecha de Pseudomonas son factores claves en la antibioterapia. Cuestiones como marcadores que detectensu origen infeccioso, factores pronósticos o el papel de las unidades de estancias cortas neumológicasson de especial relevancia. La variabilidad del tratamiento en la EPOC y su falta de adecuación a lasguías clínicas internacionales continúan siendo temas de debate. A la pobre utilización de las pautas detratamiento de las guías se añade el desigual uso de la medicación inhalada o el insuficiente uso del consejomédico o la intervención mínima en tabaquismo en todos los grupos de edad(AU)

There have been significant advances in the knowledge in the thoracic and extrathoracic aspects of chronicobstructive pulmonary disease (COPD) in the past few years. COPD is associated with numerous comorbidities,the prevalences of which have recently been evaluated. Dyspnea has been shown to be associatedwith neuropsychiatric disturbances, such as anxiety. Muscular dysfunction has been associated with inflammationand oxidative stress, in which respiratory muscle satellite cells play an important role in repair.Respiratory rehabilitation and physiotherapy must form an important part of individualised patient treatmentanalogous to the pharmacological treatment. As regards acute exacerbations, infection is the cause of75% of them, sputum characteristics and the suspicion of Pseudomonad being key factors in the antibiotictreatment. Questions, such as markers which can detect the origin of the infection, prognostic factors, orthe role of short stay pneumology units, are of particular importance. The variability in COPD treatmentsand the lack of suitable international clinical guidelines, continue to be subjects of debate. To the poor useof the treatment schemes in the guidelines, can be added the irregular uses of inhaled medication, the insufficientuse of medical advice or the low intervention in cigarette smoking in all age groups(AU)