Effects of a Pedometer-Based Walking Program in Patients with COPD-A Pilot Study.

Background and objectives: Patients with chronic obstructive pulmonary disease (COPD) suffer from impaired pulmonary function and dyspnea, which result in limited levels of physical activity, and impaired quality of life. Exercise and regular physical activity have been proven to break the vicious circle. The aim of this pilot study is to investigate the effects of a walking program on exercise capacity and quality of life in patients with COPD. Materials and Methods: Patients with COPD were randomly assigned to a pedometer group (PG) or control group (CON). Subjects in the PG walked target steps daily with a pedometer for six weeks. Before and after the program, the following measurements were performed: pulmonary function test (PFT), daily steps, Six-Minute Walk Test (6 MWT), COPD Assessment Test (CAT), and quality of life questionnaire (SF-12). Results: After this walking program, PG (n = 15) significantly improved their daily steps from 4768.4 ± 2643.3 steps to 7042.7 ± 4281.9 steps (p = 0.01). Forced vital capacity (FVC) increased from 2.5 ± 0.7 L to 2.8 ± 0.9 L (p = 0.02). CAT scores decreased from 14.9 ± 8.8 points to 11.5 ± 7.5 points (p = 0.03). In the control group (n = 11), there were no differences in any outcomes after this daily walking program. Conclusions: For patients with COPD, a daily walking program with a pedometer is beneficial in the improvement of pulmonary function, daily steps, and quality of life.

Clinical predictors of obstructive sleep apnea in Asian bariatric patients.

BACKGROUND: Obstructive sleep apnea (OSA) is a common disorder in modern society and closely associated with obesity. Because OSA increases the likelihood of complications in the perioperative period, preoperative recognition is very important for bariatric patients. Polysomnography (PSG) remains the gold standard for diagnosis, but it is a time-consuming and expensive examination. Our study is aimed at identifying practical clinical predictors of OSA for bariatric patients. METHODS: From April 2006 to December 2007, 101 morbid obese patients [41 men and 60 women, mean age 30.3 +/- 8.5, mean body mass index (BMI) 43.3 +/- 6.9] who underwent PSG before bariatric surgery were retrospectively studied. The severity of OSA was categorized by the apnea-hypopnea index (AHI) as follows: normal, 0 to 4.9; mild, 5 to 14.9; moderate, 15 to 29.9; and severe, >/=30. Chi-squared tests and linear regression models were used to assess associations between clinical parameters and AHI; P < 0.05 was considered statistically significant. RESULTS: The mean Epworth sleepiness scale (ESS) score was 8.2 +/- 4.7, and the mean AHI was 28.9 +/- 33.8 per hour. Of 101 patients, 83 patients had OSA; including severe (32.7%), moderate (17.8%), and mild (31.7%) OSA; 18.5% had no OSA. Patients with severe OSA are significantly male predominant and had higher BMI, systolic blood pressure, hemoglobin, neck and waist circumference, and ESS scores. In linear regression model analysis, the parameters which positively correlated with AHI were body weight, BMI, systolic blood pressure, diastolic blood pressure, hemoglobin, waist and neck circumferences, and the scores of ESS. Multivariate analysis confirmed that BMI, neck circumference, and scores of ESS are independent predictors of the increasing of AHI. CONCLUSIONS: OSA is highly prevalent (82.2%) in Asian bariatric patients. BMI, neck circumference, and scores of ESS are independent predictors of OSA in these patients.