scholarly journals The Effects of Exercise Therapy Moderated by Sex in Rehabilitation of COVID-19

2022 ◽  
Author(s):  
Linda Katharina Rausch ◽  
Bernhard Puchner ◽  
Jürgen Fuchshuber ◽  
Barbara Seebacher ◽  
Judith Löffler-Ragg ◽  
...  
Keyword(s):  
Lung Function ◽  
Exercise Therapy ◽  
Reference Values ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Forced Expiratory Volume ◽  
Performance Improvements ◽  
Positive Effects ◽  
Significant Difference ◽  
Pulmonary Rehabilitation Program

Abstract BackgroundPulmonary rehabilitation serves as a key component in the recovery of COVID-19 and standardized exercise therapy programs in pulmonary rehabilitation have been shown to significantly improve physical performance and lung function parameters in post-acute COVID-19 patients. However, it has not been investigated if these positive effects are equally beneficial for both sexes, especially considering a more severe physical impact of COVID-19 in men when compared to women. Therefore, the purpose of this study was to analyze outcomes of a pulmonary rehabilitation program with respect to sex differences, in order to identify sex-specific pulmonary rehabilitation requirements.MethodsData of 233 patients (40.4% females) were analyzed before and after a three-week standardized pulmonary rehabilitation program. Patients were admitted to rehabilitation due to post-acute COVID-19 illness and staged using the COVID-19 Severity Scale by Huang et al. (2021). Lung function parameters were assessed as part of the clinical routine using spirometry (ICmax, maximal inspiratory capacity) and body plethysmography (FVC, forced vital capacity; FEV1, forced expiratory volume in the first second) and functional exercise capacity was measured by the Six-Minute Walk Test (6MWT). For the comparison of lung function and walking parameters by sex, Welch-ANOVA was used, as results of Levene's test suggested significant heteroscedasticity regarding the investigated parameters (p > 0.05). When comparing post-treatment 6MWT, FEV1 and FCV to corresponding reference values, paired t-tests were used.ResultsAt post-rehabilitation, ICmax, FVC, FEV1 and 6MWT has been improved in both sexes. Females showed a significantly smaller improvement in FEV1 and ICmax (F = 5.86, ω2 = .02; p < 0.05) than males. There was no statistically significant difference in FVC and 6MWT performance improvements between men and women. After the rehabilitation stay, females made greater progress towards reference values of 6MWT (T(231) = -3.04; p < 0.01) and FEV1 (T(231) = 2.83; p < 0.01) than males.ConclusionsSex differences in the improvement of lung function parameters seem to exist when completing a three-week pulmonary rehabilitation program and should be considered when personalizing standardized exercise therapies in pulmonary rehabilitation.Trial registrationthis study was registered in the German Clinical Trials Register (DRKS00026936) on 2021/10/19.

scholarly journals The Effects of Exercise Therapy Moderated by Sex in Rehabilitation of COVID-19

2021 ◽  
Author(s):  
Linda Katharina Rausch ◽  
Bernhard Puchner ◽  
Jürgen Fuchshuber ◽  
Barbara Seebacher ◽  
Judith Löffler-Ragg ◽  
...  
Keyword(s):  
Lung Function ◽  
Exercise Therapy ◽  
Reference Values ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Forced Expiratory Volume ◽  
Performance Improvements ◽  
Positive Effects ◽  
Significant Difference ◽  
Pulmonary Rehabilitation Program

Abstract BackgroundPulmonary rehabilitation serves as a key component in the recovery of COVID-19 and standardized exercise therapy programs in pulmonary rehabilitation have been shown to significantly improve physical performance and lung function parameters in post-acute COVID-19 patients. However, it has not been investigated if these positive effects are equally beneficial for both sexes, especially considering a more severe physical impact of COVID-19 in men when compared to women. Therefore, the purpose of this study was to analyze outcomes of a pulmonary rehabilitation program with respect to sex differences, in order to identify sex-specific pulmonary rehabilitation requirements.MethodsData of 233 patients were analyzed before and after a three-week standardized pulmonary rehabilitation program. Patients were admitted to rehabilitation due to post-acute COVID-19 illness and staged using the COVID-19 Severity Scale by Huang et al. (2021). Lung function parameters were assessed as part of the clinical routine using spirometry (ICmax, maximal inspiratory capacity) and body plethysmography (FVC, forced vital capacity; FEV1, forced expiratory volume in the first second) and functional exercise capacity was measured by the Six-Minute Walk Test (6MWT). For the comparison of lung function and walking parameters by sex, Welch-ANOVA was used, as results of Levene's test suggested significant heteroscedasticity regarding the investigated parameters (p > 0.05). When comparing post-treatment 6MWT, FEV1 and FCV to corresponding reference values, paired t-tests were used.ResultsAt post-rehabilitation, ICmax, FVC, FEV1 and 6MWT has been improved in both sexes. Females showed a significantly smaller improvement in FEV1 and ICmax (F = 5.86, ω2 = .02; p < 0.05) than males. There was no statistically significant difference in FVC and 6MWT performance improvements between men and women. After the rehabilitation stay, females made greater progress towards reference values of 6MWT (T(231) = -3.04; p < 0.01) and FEV1 (T(231) = 2.83; p < 0.01) than males.ConclusionsSex differences in the improvement of lung function parameters seem to exist when completing a three-week pulmonary rehabilitation program and should be considered when personalizing standardized exercise therapies in pulmonary rehabilitation.Trial registrationthis study was registered in the German Clinical Trials Register (DRKS00026936) on 2021/10/19.

scholarly journals Pulmonary rehabilitation in Lebanon “What do we have”? A national survey among chest physicians

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254419
Author(s):  
Rebecca Farah ◽  
Wim Groot ◽  
Milena Pavlova
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Pulmonary Rehabilitation ◽  
Healthcare Providers ◽  
Rehabilitation Program ◽  
Cost Of Care ◽  
Attitudes And Practices ◽  
Positive Effects ◽  
Awareness Campaigns ◽  
Pulmonary Rehabilitation Program

Background Pulmonary rehabilitation (PR) is not very often used by physicians in Lebanon despite evidence on its positive effects on health-related quality of life. Aim This study assesses the knowledge, attitudes and practices of PR among physicians in Lebanon. In addition, the study identifies the main barriers to access to PR according to chest physicians. Insight into these issues will help to increase awareness about the need for PR programs and can contribute to designing such programs in the country. Methods A survey was conducted during the regional conference of the Lebanese Pulmonary Society. One week after the initial survey, the survey questionnaire was sent by email to all chest physicians who were registered with the Lebanese Pulmonary Society but did not attend the conference. A 25-item questionnaire was used to collect information on PR. Results Responses were analyzed using descriptive statistics. The response rate was 40%. Results show that only one-third of Lebanese chest physicians have good knowledge about the nature and multidisciplinary content of PR. Physicians generally support the current “Pulmonary Rehabilitation Program” in Beirut. Key barriers found are the lack of referral, lack of motivation by patients due to their health, cost of care and lack of qualified health care specialists in Lebanon. Conclusion Absence of awareness and education about PR among healthcare providers plays an important role in increasing access to the “Pulmonary Rehabilitation Program”. Awareness campaigns and education for physicians, health care professionals and patients should be considered to increase PR in the country.

scholarly journals The usefulness of pedometry in patients with chronic obstructive pulmonary disease

2013 ◽  
Vol 8 ◽  
Author(s):  
Nicoleta Bertici ◽  
Ovidiu Fira-Mlădinescu ◽  
Cristian Oancea ◽  
Voicu Tudorache
Keyword(s):  
Pulmonary Rehabilitation ◽  
Clinical Status ◽  
Stage Iv ◽  
Rehabilitation Program ◽  
Stage Ii ◽  
Stage Iii ◽  
Control Group ◽  
Chronic Obstructive ◽  
Positive Effects ◽  
Pulmonary Rehabilitation Program

Background: Effort tolerance and daily physical activity (DPA) are predictive of quality of life and survival in COPD patients, but still remain difficult to assess based on their daily life. The aim of this study was: how to relate pedometry to other classic parameters commonly used in pulmonary rehabilitation (PR). Methods: DPA was evaluated through pedometry. 74 patients with COPD, aged 63.55 ± 8.73 (12 stage II, FEV1 = 60.16 ± 7.78%), (29 stage III, FEV1 = 39.07 ± 6.30%), (33 stage IV, FEV1 = 23.1 ± 7.18%). The monitoring was conducted for a period of 7 days before and 6 months after a pulmonary rehabilitation program (PRP) of 3 weeks. A control group consisting of 21 patients with stable COPD was evaluated initially, but they did not undergo Pulmonary Rehabilitation Program (PRP). After 6 months the patients were re-evaluated using the same parameters. Results and discussion: The values are widely dispersed, with a maximum of 17,420 and minimum of 964 steps/24hrs. The average values acquired were: the lowest in COPD stage IV (2476→3112 steps/24 hrs, p < 0.0001), still with the highest increase over 6 months of PR + 636steps/24hrs; in COPD stage III the increase of DPA was + 597steps/24hrs over 6 months (5627→6224, p < 0.0001), COPD stage II registered the lowest increase + 540steps/24hrs (8724→9264, p < 0.13), probably because the subjects belonging to this stage had the best preserved DPA. The results show moderate correlation between pedometry and the 6MWT and the SGQ. (r = 0.5-0.7). However it demonstrated the positive effects of PRP, even after 6 months. Conclusions: DPA decreases with increasing COPD stage, it is fluctuant with every subject, dependent on clinical status, weather and daily schedule. Wearing pedometers is very easy and motivational, provided that patients realize that they are being “watched”.

scholarly journals Effectiveness of pulmonary rehabilitation in improving quality of life in patients with different COPD stages

2020 ◽  
pp. 03-08
Author(s):  
Adrian Cosmin ILIE ◽  
Alexandru CRIŞAN ◽  
Patricia HOGEA STANCA ◽  
Daniel TRĂILĂ
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Depression Score ◽  
Stage Ii ◽  
Positive Effects ◽  
Copd Patients ◽  
The Impact ◽  
Pulmonary Rehabilitation Program

Introduction. Anxiety and depression are frequently associated conditions in COPD patients, and have also significant impact on their quality of life (QoL) and on the course of the disease. Pulmonary rehabilitation (PR) is an adjuvant, non-pharmacological method used in symptomatic COPD patients. The study aimed to evaluate the impact of COPD on QoL depending on disease severity, and to assess the supposedly positive effects of a pulmonary rehabilitation program (PRP) for COPD patients. Material and method. This research included patients with COPD GOLD stages II-IV undergoing bronchodilator therapy. QoL was assessed with the self-administered St George's Respiratory Questionnaire (SGRQ), and depression with the Beck Depression Inventory (BDI). PRP included 3-5 weekly physical training sessions for an average period of 12 weeks, but not less than 3 weeks. Results. The degree of QoL impairment was moderate in stage II (41.07) and severe in stages III (70.28) and IV (81.02). The most severe depression (score 26.6 vs 2.5 in healthy subjects) was also recorded in this group. After the patients underwent all PRP, QoL reassessment at 6 months revealed statistically significant improvements in all 3 groups (p <0.05). In the GOLD COPD stage II group the average reduction was -4.38 units, in the group GOLD COPD stage III -5.37 units, and in the GOLD COPD stage IV -6.75 units. The depression score correlated with the SGRQ score, both of them being higher in the severe stages of disease. BDI administered again 6 months after PRP revealed a significant improvement in average score in all groups, respectively a decrease of -2.17 units in the COPD II group, -2.03 units in the COPD III group and -1.88 units in group COPD IV B group. Conclusion. The results of this study demonstrate a favorable impact of PRP on improving COPD associated symptoms, depression, and QoL in all the 3 monitored COPD patient groups, with statistically significant and persistent positive results over time (6 months after completion of PRP). Key words: COPD, pulmonary rehabilitation program, Quality of life (QoL), depression,

Is there any difference in pulmonary testing parameters due to spirometry reference values? A study in adolescents with idiopathic scoliosis

2021 ◽  
Author(s):  
K Politarczyk ◽  
Ł Stepniak ◽  
M Kozinoga ◽  
T Kotwicki
Keyword(s):  
Lung Function ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Reference Values ◽  
Forced Vital Capacity ◽  
Subgroup Analysis ◽  
Forced Expiratory Volume ◽  
Radiographic Evaluation ◽  
Significant Difference ◽  
Predicted Values

The Global Lung Function Initiative (GLI 2012) presented multi-ethnic spirometry reference values that are recommended to be used instead previous Zapletals’ reference values. The study aimed to compare the values of the pulmonary parameters calculated according to the Zapletals’ versus the GLI 2012 reference values in adolescents with idiopathic scoliosis. Preoperative pulmonary testing and radiographic evaluation were performed in 39 adolescents (29 females, 10 males) aged 12–17 years. The thoracic Cobb angle ranged 50°–104°. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured. The percentages of predicted values of FVC (%FVC) and the FEV1 (%FEV1) were calculated according to the Zapletals’ reference values and to the GLI 2012 reference values. The subgroup analysis was performed for the subjects with Cobb curve 50°–74° (N=26) versus the subjects with Cobb curve 75°–104° (N=13). Mean %FVC was significantly higher using the Zapletals’ reference values 86.1%±16.4 versus 84.6%±15.6 using the GLI 2012 reference values, p=0.0116. Mean %FEV1 was significantly higher using the Zapletals’ reference values 84.5%±18.2 versus 80.0%±16.3 using GLI 2012 reference values, p=0.000001. The subgroup analysis revealed significant difference of %FVC in moderate (p=0.033974) and no difference in severe curves (p=0.1993). The %FEV1 differences were significant in both moderate (p=0.000011) and severe curves (p=0.0334). The study demonstrated that a significant difference might be observed in the spirometry parameters due to the applied reference values. These differences might be taken into account during the spirometry examination interpretation.

scholarly journals Pulmonary Rehabilitation Improves Functional Capacity in Patients 80 Years of Age or Older

2004 ◽  
Vol 11 (6) ◽  
pp. 407-413 ◽  
Author(s):  
Marcel A Baltzan ◽  
Hany Kamel ◽  
Arlene Alter ◽  
Michael Rotaple ◽  
Norman Wolkove
Keyword(s):  
Pulmonary Rehabilitation ◽  
Older Patients ◽  
Chronic Respiratory Disease ◽  
Rehabilitation Program ◽  
Forced Expiratory Volume ◽  
Global Function ◽  
Younger Patients ◽  
Medical Diagnoses ◽  
Functional Scores ◽  
Pulmonary Rehabilitation Program

OBJECTIVES:There is limited evidence that pulmonary rehabilitation improves exercise capacity in older patients with chronic respiratory disease. The objective of the present study was to determine whether patients 80 years of age or older gain similar benefits from pulmonary rehabilitation as do younger patients.DESIGN:Outcomes were compared in 230 consecutive inpatients with moderate to severe lung disease who participated in a comprehensive pulmonary rehabilitation program during a one-year period. Outcomes included 6 min walk test distance (6MWT), the number of stairs completed in 2 min (2MST), Borg dyspnea scores after exertion and objective functional scores.RESULTS:There were no differences between older (80 to 91 years, n=43) and younger patients (n=187) with respect to sex, forced expiratory volume in 1 s (mean 0.77 L versus 0.72 L) or number of chronic medical diagnoses (2.4 versus 2.7). Older patients were less frequently survivors of mechanical ventilation (2.3% versus 16%). Baseline 6MWT (133 m versus 144 m; P=0.48) and 2MST (5.2 laps versus 6.5 laps; P=0.067) were similar but global function was lower (85 versus 89; P=0.040) in older patients than in younger patients, respectively. After pulmonary rehabilitation, all outcomes improved significantly regardless of age (all before-after comparisons P<0.0001). Younger patients improved with a higher discharge 6MWT (231 m versus 185 m; P=0.004) and similar discharge 2MST (9.3 laps versus 7.9 laps; P=0.070) compared with older patients. Global function at discharge remained lower in older patients than younger patients (91 versus 94; P=0.002). The duration of rehabilitation and length of stay were similar between the two groups.CONCLUSION:A comprehensive inpatient pulmonary rehabilitation program is beneficial in selected patients 80 years of age or older.

Maintaining Effects of Pulmonary Rehabilitation at Home in Chronic Obstructive Pulmonary Disease: A Systematic Literature Review

2021 ◽  
pp. 108482232199037
Author(s):  
Duarte Pinto ◽  
Lissa Spencer ◽  
Soraia Pereira ◽  
Paulo Machado ◽  
Paulino Sousa ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Literature Review ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Maintenance Strategies ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Pulmonary Rehabilitation Program

To systematize strategies that may support patients with Chronic Obstructive Pulmonary Disease to maintain the effects of pulmonary rehabilitation over time. This systematic literature review was conducted, and the evidence was electronically searched in the Web of Science, Scopus, and EBSCO databases. This review included randomized controlled clinical trials, published until September 2019, that addressed components of an unsupervised home-based pulmonary rehabilitation program, maintenance strategies following outpatient pulmonary rehabilitation programs, as well as data on outcomes for quality of life, exercise performance, and dyspnea. A final sample of 5 articles was obtained from a total of 1693 studies. Data for final synthesis were grouped into 2 categories: components of unsupervised home-based pulmonary rehabilitation programs and maintenance strategies. An unsupervised home-based pulmonary rehabilitation program should consist of an educational component, an endurance training component, and a strength training component. When patients are transferred to the home environment, it is important to include more functional exercises specifically adapted to the patient’s condition, goals, and needs.

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