Measurement properties of physical activity in adults with bronchiectasis: A systematic review protocol.

People with bronchiectasis reduce their physical activity (PA) due to muscle weakness, dyspnea, fatigue, reduced exercise capacity and frequent cough with expectoration. Patient-reported and objective physical assessment methods have been used to evaluate PA in people with bronchiectasis. In the literature, significant differences in the PA measured using patient-reported outcome measures when compared with the objective methods. Given the availability of many PA assessment tools, it is tedious for the clinician or researcher to choose an outcome measure for clinical practice or research. The evidence on validity and reliability in bronchiectasis are unclear. Objectives: To identify the PA assessment tools, describe and evaluate the literature on psychometric properties of instruments measuring and analyzing PA. Methods: The search will be conducted in PubMed/Medline, Cochrane Central Register of Controlled Studies, Scopus and EMBASE databases. The keywords, index terms and synonyms of the following words will be used: bronchiectasis, physical activity, and outcome measures. Published studies of adult with clinical and/ or radiologically diagnosed bronchiectasis, aged >18 years, any gender and studies that assessed PA and/or if there are reports on measurement properties of PA will be included in the review. Studies using qualitative research methods, narrative reviews, letters to editors and editorials will be excluded. The quality of the study will be assessed and data will be extracted. Any disagreement will be resolved in the presence of an author not involved in the screening or selecting studies. Discussion: By assessing the quality of studies on measurement properties, this review will help researchers choose the outcome measure to evaluate the effects of interventions on PA. This review will identify the suite of outcome measures of PA for people with bronchiectasis that can be used for research and clinical purpose.

Role of Angiotensin Converting Enzyme-2 and its modulation in disease: exploring new frontiers.

Angiotensin Converting Enzyme-2 (ACE2), an important enzyme in the Renin Angiotensin Aldosterone System, degrades Angiotensin II (Ang II) into Angiotensin-(1-7) (Ang-(1-7)), whose actions are opposite to that of Ang II. Interestingly, SARS CoV-2 virus entry into human cells is mediated by ACE2. ACE2 receptors that are widely expressed in lungs and various other organs. Ang-(1-7) seems to have favorable effects on lungs, by preventing fibrosis in lung inflammation models, and exerts a similar action in cardiac and renal pathologies as well. Thus, modulation of Ang-(1-7) can be of potential benefit in chronic as well as acute inflammatory diseases affecting lungs and other organs. Upregulation of ACE2 by statins in different organs, and its consequent beneficial effects, have been demonstrated in many experimental studies, and also in a few clinical ones. This review aims at probing the role of ACE2 and its therapeutic modulation in pulmonary and extra pulmonary diseases, including COVID-19.

Correlation between physical activity, cardiorespiratory fitness and heart rate variability among young overweight adults.

Objective: Cardiac autonomic function assessed by heart rate variability (HRV) is a non-invasive, quantitative, and reliable marker of measurement. An altered cardiac autonomic function among overweight individuals predisposes them to a greater risk of developing cardiovascular diseases. The present study aims to determine the correlation between physical activity, cardiorespiratory fitness and heart rate variability among young overweight adults. Methods: A total of 45 participants (23 men and 22 women) were enrolled in the cross-sectional study with inclusion criteria as follows: aged between 18-30 years, body mass index (kg/m2) between 25-29.9 kg/m2, and without any known or diagnosed medical condition. Physical activity level and cardiorespiratory fitness were measured using the Global Physical Activity Questionnaire and Bruce treadmill protocol test, respectively. Cardiac autonomic function was measured using a 5-min short-term heart rate variability recording. The time and frequency domain measures of HRV were used for analysis. Results: The mean age of study participants was 22.53 ± 1.58 years and mean body mass index was 27.38 ± 1.51 kg/m2. Among young overweight adults, cardiorespiratory fitness and physical activity were not correlated with Root mean square of successive RR interval differences, Percentage of successive RR intervals that differ by more than 50 ms, and Ratio of LF [ms2]/HF [ms2]. Conclusion: The study found no correlation between physical activity and cardiorespiratory fitness with heart rate variability among young overweight individuals.

Barriers to pulmonary rehabilitation - A narrative review and perspectives from a few stakeholders.

Pulmonary Rehabilitation (PR) is an essential and comprehensive intervention recommended in the management of people with chronic respiratory diseases (CRD). Scientific evidence suggests significant health benefits with respect to repeated hospital admissions, exercise tolerance and Health Related Quality of Life (HRQoL). However, the uptake and completion of PR programs are globally low. In order to understand the factors contributing to underutilization of PR, it is important to review and recognize the barriers to PR program. A literature search was conducted on Medline (PubMed) database. After reviewing the title and abstracts, full text articles were scrutinized for their relevance. Twenty-two studies involving factors affecting the uptake, participation and completion of PR program were included in this review. Reported barriers to PR were healthcare system, healthcare professional and patient related factors. Primary factors related to healthcare system and healthcare professionals were fewer PR centers, accessibility inconvenience, lack of awareness of PR program, low knowledge of referral process and lack of interdisciplinary teamwork. Difficulties faced by patients to take up and/or to complete PR programs were lack of transportation, co-morbidities, lack of perceived benefits, socio-economic status and lack of funding facilities. Identified and reported barriers resulted into discontinuity between knowledge of health benefits and utilization of PR service for patients with CRDs. Addressing the barriers would accelerate the healthcare professionals' referral and patients to avail the health benefits of rehabilitation service.

Comparison of reaction time and functional balance in chronic obstructive pulmonary disease and healthy participants.

BACKGROUND: Reaction time is one of the components of functional balance and could contribute to balance impairment. Information regarding this relationship is scant among Chronic Obstructive Pulmonary Disease (COPD) participants. OBJECTIVES: To compare stepping reaction time between participants with COPD and age; gender-matched healthy individuals to find out whether reaction time in COPD population is affected. METHODS: This cross-sectional study included 41 COPD participants and 41 age and gender-matched healthy individuals. All the participants underwent measurements of stepping reaction time (SRT) and timed up and go test (TUG). RESULTS: SRT was significantly higher in COPD participants compared to healthy individuals [median of difference- 350 milliseconds (110, 830), p < 0.001]. TUG was significantly higher in COPD participants compared to healthy individuals [median of difference = 2.82 seconds (0.34 and 4.5), p < 0.001]. CONCLUSIONS: Participants with COPD exhibit marked increase in SRT and demonstrate a deficiency in functional balance compared to the healthy participants.

The initial steps in pulmonary rehabilitation: How it all began?

Pulmonary rehabilitation plays a vital role in improving symptom, thereby enhancing health-related quality of life in patients with chronic obstructive pulmonary disease. We here with review is highlighting the landmark changes and recommendation for pulmonary rehabilitation since inception to till date. We also discuss the utilization of oxygen therapy, various measures of exercise training, and adherence strategy recommendation for betterment of the patient performance in their activity of daily living life.

Frequency and Factors Associated With Honorary Authorship in Indian Biomedical Journals: Analysis of Papers Published From 2012 to 2013.

Honorary authorship is the inclusion of an author on an article whose contribution does not warrant authorship. We conducted an Internet-based survey among first authors publishing in Indian biomedical journals from 2012 to 2013 to study the frequency and factors associated with honorary authorship. The response rate was 27% (245/908) with the prevalence of perceived, International Committee of Medical Journal Editors (ICMJE)-defined, and unperceived honorary authorship of 20.9% (50/239), 60% (147/245), and 46.9% (115/245), respectively. Those residing in India were found to list more honorary authors. We hope to increase awareness of the ICMJE authorship guidelines and the general issue of honorary authorship among researchers in India and elsewhere.

Instructions to Prospective Authors by Indian Biomedical Journals: An Opportunity to Promote Responsible Conduct of Research.

Journals provide instructions to prospective authors to facilitate the process of manuscript publication. The information provided under such instructions could be a potential opportunity to promote responsible conduct of research (RCR). We analyzed 74 Indian biomedical journals for the type of information provided in the "instructions to authors" section and adherence to the International Committee of Medical Journal Editors (ICMJE) recommendations. Among the 71 journals that had an "instructions to authors" section, 53 journals adhered to ICMJE recommendations. We discuss sections of the ICMJE recommendations detailed by Indian biomedical journals under the "instructions to authors" section and emphasize components that require greater exposure.

Mobilization of patients in neurological Intensive Care Units of India: A survey.

CONTEXT: The rehabilitation needs of the patients in neurological Intensive Care Units (ICUs) vary from that of a medical ICU patient. Early mobilization is known to improve the various neurological outcomes in patients admitted to neurological ICUs, although little is known about the practice pattern among physiotherapists. The mobilization practice pattern may vary significantly than that of developed countries due to the reasons of differences in training of professionals, availability of equipment, and financial assistance by health insurance. AIM OF THE STUDY: To study the current mobilization practices by the physiotherapists in neurological ICUs of India. SUBJECTS AND METHODS: A cross-sectional survey was conducted with a content validated questionnaire about the mobilization practices. Online questionnaire was distributed to physiotherapists working in neurological ICUs of India. Descriptive statistics were used. RESULTS: Out of 185 e-mails sent, 82 physiotherapists completed the survey (survey response rate = 44%). Eighty participants (97.6%) mentioned that the patients received some form of mobilization during the day. The majority of the physiotherapists (58.5%), "always" provided bed mobility exercises to their patients when it was found appropriate for the patients. Many physiotherapists (41.5%) used tilt table "sometimes" to introduce orthostatism for their patients. CONCLUSION: Mobilization in various forms is being practiced in the neurological ICUs of India. However, fewer mobilization sessions are conducted on weekends and night hours in Indian Neurological ICUs.

Publication speed and advanced online publication: Are biomedical Indian journals slow?

OBJECTIVE: The aim of this study was to identify the publication speed (peer review time and publication time) of biomedical Indian journals and identify the journals having the facility of advance online publication (AOP). MATERIALS AND METHODS: Biomedical Indian journals were identified from the Journal Citation Report of 2013. Thirty original articles published between January 2012 and June 2014 were systematically selected from each journal. Information about the date of submission, revision, and acceptance were extracted from the full text of the articles. Median peer review time (submission to acceptance) and publication time (acceptance to AOP/electronic publication) were calculated for each journal. RESULTS: Of the 19 journals studied, 5 (26.3%), 15 (78.9%), and 6 (31.6%) journals did not mention details about date of submission, date of revision, and date of acceptance, respectively. The individual median peer review time of the journals ranged from 87 to 377.5 days and the combined median peer review time (interquartile range) was 143.5 days (105.5, 238). The individual median publication time ranged from 14 to 349 days. The publication time for journals with AOP was significantly lesser (29.5 [19.6, 50.6] vs. 146.5 [126.5, 202.5]; P = 0.02) compared to journals without AOP. Impact factor of the journal did not correlate with the publication speed. The facility of AOP was provided by 6 (31.6%) journals. CONCLUSIONS: Overall, the peer review time and publication time of biomedical Indian journals included in our study seems to be fairly long. Less than one-third of biomedical Indian journals provide the facility of AOP.

Chest physiotherapy techniques in neurological intensive care units of India: A survey.

CONTEXT: Neurological intensive care units (ICUs) are a rapidly developing sub-specialty of neurosciences. Chest physiotherapy techniques are of great value in neurological ICUs in preventing, halting, or reversing the impairments caused due to neurological disorder and ICU stay. However, chest physiotherapy techniques should be modified to a greater extent in the neurological ICU as compared with general ICUs. AIM: The aim of this study is to obtain data on current chest physiotherapy practices in neurological ICUs of India. SETTINGS AND DESIGN: A tertiary care hospital in Karnataka, India, and cross-sectional survey. SUBJECTS AND METHODS: A questionnaire was formulated and content validated to assess the current chest physiotherapy practices in neurological ICUs of India. The questionnaire was constructed online and a link was distributed via E-mail to 185 physiotherapists working in neurological ICUs across India. STATISTICAL ANALYSIS USED: Descriptive statistics. RESULTS: The response rate was 44.3% (n = 82); 31% of the physiotherapists were specialized in cardiorespiratory physiotherapy and 30% were specialized in neurological physiotherapy. Clapping, vibration, postural drainage, aerosol therapy, humidification, and suctioning were used commonly used airway clearance (AC) techniques by the majority of physiotherapists. However, devices for AC techniques such as Flutter, Acapella, and standard positive expiratory pressure devices were used less frequently for AC. Techniques such as autogenic drainage and active cycle of breathing technique are also frequently used when appropriate for the patients. Lung expansion therapy techniques such as breathing exercises, incentive spirometry exercises, and positioning, proprioceptive neuromuscular facilitation of breathing are used by majority of physiotherapists. CONCLUSIONS: Physiotherapists in this study were using conventional chest physiotherapy techniques more frequently in comparison to the devices available for AC.