Effects of home-based lower limb resistance training on muscle strength and functional status in stable Chronic obstructive pulmonary disease patients.

AIMS AND OBJECTIVES: This study aimed to determine the effect of home-based lower limb resistance training (LLRT) in patients with stable COPD. BACKGROUND: Pulmonary rehabilitation (PR) in COPD patients has been substantially investigated, but the rehabilitation components differ among studies. Few works have focused on home-based LLRT. Furthermore, few studies have assessed muscle strength and functional status by isokinetic/isometric extensor muscle peak torque (PT) and five-repetition sit-to-stand test (FTSST), respectively. DESIGN: A randomised controlled design was adopted. METHODS: (i) The home-based LLRT consisted of six sets of lower limb training cycles by self-gravity resistance and Thera-band resistance at 8-12RM, 20-30 min/session and 3 sessions/week for 12 weeks. (ii) The intervention group (n = 25) received routine PR guidance and home-based LLRT, whereas the control group (n = 22) received routine PR guidance only. The muscle strengths, FTSST durations, 6-min walking distances (6MWDs) and COPD assessment test results at enrolment and week 12 were compared. RESULTS: Relative to the baseline findings, all the indexes of muscle strength (isometric extensor muscle PT, isometric extensor muscle PT to body weight ratio [PT/BW], isokinetic extensor muscle PT and isokinetic extensor muscle PT/BW) did not significantly change in the intervention group. Meanwhile, no significant intragroup difference was noted among the indexes of muscle strength (except for isometric extensor muscle PT) in the control group. The FTSST decrease was significant between and within groups. By contrast, the 6MWD significantly increased within both groups, but not between the groups. The COPD assessment tool score decreased significantly within the intervention group. CONCLUSIONS: Compared with routine PR guidance, home-based LLRT can improve not only the muscle strength and exercise endurance but also the lower limb functional status. RELEVANCE TO CLINICAL PRACTICE: Our developed home-based LLRT intervention is simple, safe and feasible in stable COPD patients and could hence be promoted in clinical practice.

Effectiveness of Dyadic Psychoeducational Intervention on Cancer Patients and Their Caregivers: A Systematic Review and Meta-analysis.

BACKGROUND: Dyadic psychoeducational intervention targets the dyads of cancer patients and caregivers as active participants in partnership, which can potentially address the needs and challenges faced by patients with cancer and their caregivers. However, there is insufficient evidence on the effectiveness of the intervention on psychological health and illness-related outcomes among the dyads. OBJECTIVE: To systematically examine the dyadic psychoeducational intervention of cancer patients and their caregivers on psychological health and illness-related outcomes. METHODS: Cochrane Library, EMBASE, CINAHL, PsycINFO, PubMed, Web of Science, and 4 Chinese databases were searched from inception to May 29, 2022. Two investigators independently extracted data and evaluated methodological quality. RevMan 5.4 was used for meta-analysis; heterogeneity was evaluated using Higgins' I2 (%). Standardized mean difference (SMD) with a 95% confidence interval (CI) was used to assess the effects. RESULTS: Eight randomized controlled trials that involved 1234 dyads were collected. Meta-analysis showed that the intervention was effective in reducing the dyadic depression (patients' SMD, -0.41 [95% CI, -0.78 to -0.04; P = .03]; caregivers' SMD, -0.70 [95% CI, -1.31 to -0.09; P = .03]). It also improved caregivers' quality of life (SMD, -0.29 [95% CI, -0.56 to -0.03; P = .03]), whereas no significant effect was found on patients' quality of life. Dyadic results including anxiety, self-efficacy, disease communication, and appraisals of illness/caregiving were observed. CONCLUSION: Dyadic psychoeducational intervention reduced the dyadic depression. It also improved caregivers' quality of life. IMPLICATIONS FOR PRACTICE: Nurses can apply dyadic psychoeducational intervention in clinical practice. More studies are needed to draw higher-quality conclusions and investigate the effects on psychological health and illness-related outcomes in cancer patients and caregivers.

Impaired Skeletal Muscle in Patients with Stable Chronic Obstructive Pulmonary Disease (COPD) Compared with Non-COPD Patients.

Purpose: This study was designed to investigate the differences in skeletal-muscle atrophy between patients with stable chronic obstructive pulmonary disease (COPD) and healthy controls; associated factors were also considered. The study comprised selected residents of communities near the First Affiliated Hospital of Soochow University in Suzhou City, East China. Patients and Methods: Included in this study were 123 COPD patients and 60 controls. All patients completed spirometry as well as examinations to determine their functional exercise capacity, body composition, and handgrip strength (HGS). Results: COPD patients had less fat-free mass (FFM), a lower FFM index (FFMI), and a lower 6-min walking distance (6MWD) compared with controls (P = 0.007, P = 0.020, and P < 0.001, respectively) (FFMI: 17.59 ± 1.83 vs 18.34 ± 1.64). The HGS of these patients was also lower compared with that of controls (32.88 ± 7.84 vs 35.48 ± 7.42), and HGS tended toward statistical significance (P = 0.064, respectively). In multivariate analysis, age (ß = -0.107, P < 0.001), gender (ß = 0.212, P < 0.001), body mass index (BMI) (ß = 0.462, P < 0.001), FEV1% (ß = 0.108, P = 0.009), and calf circumference (CC) (ß = 0.457, P < 0.001) were significantly associated with FFMI. Conclusion: Impaired skeletal muscle mass was more common in COPD patients than in controls. Multiple regression analysis showed that CC may be used to detect the degree of impairment, particularly by health-care providers working outside of the hospital.

Association Between Anthropometric Indices and Skeletal-Muscle Atrophy in Chinese Patients with Stable Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.

Purpose: Anthropometric indices are simple indicators of patient nutritional status. However, the association between these indices and skeletal-muscle atrophy in patients with stable chronic obstructive pulmonary disease (COPD) has not been fully investigated. In this study, we evaluated this association. Patients and Methods: We recruited 123 outpatients with stable COPD from a general hospital in China from 2020 to 2021. We recorded their demographic characteristics, including age, sex, course of illness, dyspnea score, body mass index (BMI), force expiratory volume in 1 second (FEV1), forced vital capacity (FVC), smoking status, and severity grading. In addition, patients' anthropometric indices, including fat-free mass index (FFMI) and appendicular skeletal-muscle mass index (ASMI), were measured using a body composition analyzer, and measurements were taken of the triceps skinfold (TSF), midarm circumference (MAC), and calf circumference (CC). We drew and analyzed a receiver operating characteristic (ROC) curve to identify the best intercept point value for the assessment of skeletal-muscle atrophy. Results: The TSF, MAC, CC, FFMI, and ASMI of COPD patients were 1.08 ± 0.44 cm, 26.39 ± 2.92 cm, 34.5 ± 3.06 cm, 17.49 ± 1.86 kg/m2, and 8.17 ± 0.90 kg/m2, respectively. These anthropometric indices had a significant positive correlation with skeletal-muscle mass (correlation values, 0.481-0.820). CC was strongly correlated with both FFMI and ASMI. The ROC curve showed an area-under-the-curve (AUC) value of 0.873-0.959. Conclusion: Anthropometric indices were correlated with skeletal-muscle mass. CC showed the best diagnostic value in COPD patients, suggesting its effectiveness as a simple method for assessing skeletal-muscle atrophy and identifying patients with a noticeable reduction in muscle mass. Such patients require early, multidisciplinary intervention.

Factors Influencing Compliance with Auricular Acupressure Therapy in Patients with Cancer-Related Fatigue.

BACKGROUND: Patient compliance can influence the effect of auricular acupressure used to manage cancer-related fatigue (CRF). OBJECTIVE: To explore the barriers and facilitators affecting patients' compliance with treatment. METHODS: The maximum difference sampling method was used to conduct qualitative interviews with 11 CRF patients undergoing auricular acupressure therapy. The interview data were analyzed by Colaizzi's seven-step analysis. RESULTS: Convenience and acceptability of the therapy, preliminary effects of its implementation, fully believing in the benefits of auricular acupressure and being habituated to the therapy, help and reminder from family members are the facilitating factors to improve patient compliance with auricular acupressure therapy, while the hindering factors include having doubts about the effect of acupressure resulting in interruption, having limited access to medical resources, deterioration of the condition resulting in self-abandonment, and weak family support. CONCLUSION: In clinical nursing practice, attention should be paid to the analysis of the facilitating and hindering factors during the implementation of auricular acupressure therapy as well as the development of targeted intervention measures to improve patient compliance so as to enhance the effectiveness of auricular acupressure.

Factors associated with appendicular skeletal muscle mass among male Chinese patients with stable chronic obstructive pulmonary disease: A hospital-based cross-sectional study.

Limbs muscle wasting is a common disorder in patients with chronic obstructive pulmonary disease (COPD) that limits daily activities and exercise intolerance, especially in males. The present study aimed to estimate the prevalence of appendicular skeletal muscle mass (ASM) in male patients with stable COPD. In addition, factors associated with parameters of ASM were also investigated.We recruited 116 male patients with stable COPD from the outpatient clinic between September 2016 and December 2017. For each patient, we obtained demographic characteristics and measured post-bronchodilator forced expiratory volume in 1 second, symptoms, exacerbations history, and ASM. ASM was defined as the sum of the muscle masses of the 4 limbs.Appendicular skeletal muscle mass index (ASMI) in male patients with stable COPD was 8.2 ±â€Š0.9 kg/m, and the prevalence of low skeletal muscle mass was 7.8% (9 of 116 patients). Multiple linear-regression analysis showed that body mass index, occupation, fat-free mass index, and the modified medical research council scale were significantly correlated with ASMI. Compared with nonexercise group, lower limb muscle mass and ASM were significantly improved in physical exercise group.Underweight, retirement, fat-free mass depletion, and severe dyspnea are all risk factors for ASM in male patients with stable COPD. Our findings also justify the importance of exercise training in improving ASM.

Pulmonary tuberculosis with false-positive 18F-fluorodeoxyglucose positron emission tomography mimicking recurrent lung cancer: A case report.

Recurrent lung cancer is a common clinical condition. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is currently the predominant non-invasive imaging technique used for the detection of tumor recurrence. In the present study, the case of a 67-year-old male suspected to have postoperative recurrence of primary lung cancer was examined. Chest computed tomography (CT) scans identified a subpleural nodule grown within a short time period, along with the occurrence of multiple patchy shadows on the right lung. PET-CT scans revealed an increased FDG uptake in the surgical site, which exhibited features of a malignant disease. However, a video-assisted thoracoscopic biopsy provided the diagnosis of tuberculosis and guided further appropriate treatment. In conclusion, further evaluation is required in all patients with suspected metastatic and recurrent carcinoma.

Sudden and rapid progression of lung affectation but stability in kidney function: a case report of anti-neutrophil cytoplasmic antibody-associated vasculitis.

We report the case of a patient with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) who exhibited sudden progression of lung infiltration while maintaining stable kidney function. The 69-year-old man was diagnosed with AAV and renal insufficiency 4 years ago. Pulmonic affectation was detected in the right lower lobe of lung by a computed tomography (CT) scan. After beginning cyclophosphamide pulse therapy and sequential therapy with low-dose prednisone, he underwent a 4-year follow-up to detect changes in hemoglobin levels and serum creatinine levels, and had chest CT examinations. The CT scan and creatinine assay showed stable pulmonic fibrosis and kidney function. Although there was no increase of creatinine and detectable perinuclear ANCA, the patient suffered a pulmonary hemorrhage and levels of hemoglobin became progressive lower; the lung infiltration was found to be enlarged compared to the last examination the previous year. After immunosuppressive therapy for one week, the lung fibrosis was progressive, increased pulmonary hemorrhage occurred, and the patient died due to respiratory failure but not end-stage renal failure.