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

Reduced balance function has been observed during balance challenging conditions in the chronic obstructive pulmonary disease (COPD) population and is associated with an increased risk of falls. This study aimed to examine postural balance during quiet standing with eyes open and functional balance in a heterogeneous group of COPD and non-COPD (control) subjects, and to identify risk factors underlying balance impairment using a large panel of methods. In COPD and control subjects, who were mostly overweight and sedentary, postural and functional balance were assessed using center-of-pressure displacement in anterior-posterior (AP) and medio-lateral (ML) directions, and the Berg Balance Scale (BBS), respectively. COPD showed 23% greater AP sway velocity (p = 0.049). The presence of oxygen therapy, fat mass, reduced neurocognitive function, and the presence of (pre)diabetes explained 71% of the variation in postural balance in COPD. Transcutaneous oxygen saturation, a history of exacerbation, and gait speed explained 83% of the variation in functional balance in COPD. Neurocognitive dysfunction was the main risk factor for postural balance impairment in the control group. This suggests that specific phenotypes of COPD patients can be identified based on their type of balance impairment.

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ASSESSMENT OF LOWER LIMB REACTION TIME IN SUBJECTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2016.120 ◽

2016 ◽

Vol 4 (3) ◽

pp. 1503-1509

Author(s):

Ipsita Pattanaik ◽

◽

Veena Kiran Nambiar ◽

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Reaction Time ◽

Pulmonary Disease ◽

Lower Limb ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

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Safety and Pharmacokinetics of Multiple Doses of Aclidinium Bromide, a Novel Long-Acting Muscarinic Antagonist for the Treatment of Chronic Obstructive Pulmonary Disease, in Healthy Participants

The Journal of Clinical Pharmacology ◽

10.1177/0091270009336353 ◽

2009 ◽

Vol 49 (10) ◽

pp. 1239-1246 ◽

Cited By ~ 38

Author(s):

Josep M. Jansat ◽

Rosa Lamarca ◽

Gonzalo de Miquel ◽

Andreas Schrödter ◽

Barbara Miletzki ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Muscarinic Antagonist ◽

Multiple Doses ◽

Aclidinium Bromide ◽

Long Acting ◽

Healthy Participants

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Drug Metabolism in Severe Chronic Obstructive Pulmonary Disease: A Phenotyping ‘Cocktail’ Study

10.22541/au.160780157.71700181/v1 ◽

2020 ◽

Author(s):

Richard McNeill ◽

Mei Zhang ◽

Michael Epton ◽

Matthew Doogue

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Drug Metabolism ◽

Pulmonary Disease ◽

Fold Increase ◽

Drug Clearance ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Clinically Significant ◽

Healthy Participants ◽

Severe Copd

Aims To evaluate the effect of severe chronic obstructive pulmonary disease (COPD) on drug metabolism by comparing the pharmacokinetics of patients with severe COPD with healthy volunteers and using the modified ‘Inje’ drug cocktail. Methods This was a single-centre pharmacokinetic study with 12 healthy participants and 7 participants with GOLD D COPD. Midazolam 1 mg, dextromethorphan 30 mg, losartan 25 mg, omeprazole 20 mg, caffeine 130 mg, and paracetamol 1000 mg were simultaneously administered and intensive pharmacokinetic sampling was conducted over 8 hours. Drug metabolism by CYP3A4, CYP2D6, CYP2C9, CYP2C19, CYP1A2, UGT1A6 and UGT1A9 in participants with COPD were compared with phenotypes in healthy controls. Results The oral clearance (95% CI) in participants with COPD relative to controls was: midazolam 63% (60-67%), dextromethorphan 72% (40-103%), losartan 53% (52-55%), omeprazole 35% (31-39%), caffeine 52% (50-53%), and paracetamol 73% (72-74%). There was a five-fold increase in AUC for omeprazole and approximately two-fold increases for caffeine, losartan, dextromethorphan, and midazolam. The AUC of paracetamol, which is mostly glucuronidated, was increased by about 60%. Conclusion Severe COPD is associated with a clinically significant reduction in drug clearance. This may be greater for cytochrome P450 substrates than for glucuronidated drugs. This supports reduced starting doses when prescribing for patients with severe COPD.

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A Novel Inhaled Dry-Powder Formulation of Ribavirin Allows for Efficient Lung Delivery in Healthy Participants and Those with Chronic Obstructive Pulmonary Disease in a Phase 1 Study

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02267-19 ◽

2020 ◽

Vol 64 (5) ◽

Cited By ~ 5

Author(s):

Etienne F. Dumont ◽

Amanda J. Oliver ◽

Chris Ioannou ◽

Julia Billiard ◽

Jeremy Dennison ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Respiratory Infections ◽

Phase 1 ◽

Systemic Exposure ◽

Antiviral Agent ◽

Chronic Obstructive ◽

Dry Powder ◽

Obstructive Pulmonary Disease ◽

Healthy Participants

ABSTRACT Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition, causing progressive decline in lung function leading to premature death. Acute exacerbations in COPD patients are predominantly associated with respiratory viruses. Ribavirin is a generic broad-spectrum antiviral agent that could be used for treatment of viral respiratory infections in COPD. Using the Particle Replication In Nonwetting Templates (PRINT) technology, which produces dry-powder particles of uniform shape and size, two new inhaled formulations of ribavirin (ribavirin-PRINT-CFI and ribavirin-PRINT-IP) were developed for efficient delivery to the lung and to minimize bystander exposure. Ribavirin-PRINT-CFI was well tolerated in healthy participants after single dosing and ribavirin-PRINT-IP was well tolerated in healthy and COPD participants after single and repeat dosing. Ribavirin-PRINT-CFI was replaced with ribavirin-PRINT-IP since the latter formulation was found to have improved physicochemical properties and it had a higher ratio of active drug to excipient per unit dose. Ribavirin concentrations were measured in lung epithelial lining fluid in both healthy and COPD participants and achieved target concentrations. Both formulations were rapidly absorbed with approximately dose proportional pharmacokinetics in plasma. Exposure to bystanders was negligible based on both the plasma and airborne ribavirin concentrations with the ribavirin-PRINT-IP formulation. Thus, ribavirin-PRINT-IP allowed for an efficient and convenient delivery of ribavirin to the lungs while minimizing systemic exposure. Further clinical investigations would be required to demonstrate ribavirin-PRINT-IP antiviral characteristics and impact on COPD viral-induced exacerbations. (The clinical trials discussed in this study have been registered at ClinicalTrials.gov under identifiers NCT03243760 and NCT03235726.)

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Functional Balance in Older Adults With Chronic Obstructive Pulmonary Disease

Journal of Aging and Physical Activity ◽

10.1123/japa.2012-0319 ◽

2014 ◽

Vol 22 (3) ◽

pp. 357-363 ◽

Cited By ~ 9

Author(s):

Cristina Jácome ◽

Joana Cruz ◽

Raquel Gabriel ◽

Daniela Figueiredo ◽

Alda Marques

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Older Adults ◽

Pulmonary Disease ◽

Normative Values ◽

Chronic Obstructive ◽

Timed Up And Go ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Balance Impairment ◽

Functional Balance

This study assessed functional balance among older adults at all grades of chronic obstructive pulmonary disease (COPD) and explored balance impairment predictors. A cross-sectional study with outpatients with COPD (N = 160; M = 72.2 years, SD = 7.9; mean forced expiratory volume in 1 s = 63.8% predicted, SD = 23.7) was conducted. The Timed Up and Go (TUG) test was used to assess functional balance. Functional balance impairment was defined as a TUG score exceeding the upper limit of the confidence intervals of normative values for healthy older adults. Participants performed the TUG test in 11.0 s (SD = 4.8 s). Functional balance impairment was present in 44.4% of the participants and was significantly more frequent in severe to very severe COPD (62.5%). Body mass index (odds ratio [OR] = 1.12), number of medications (OR = 1.20), restriction in recreational activities (OR = 1.66), and depression score (OR = 1.14) were multivariate predictors of functional balance impairment. Functional balance impairment is present in early COPD, although more evident at advanced grades. These findings highlight the importance of balance assessment in older patients at all COPD grades.

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Reductions in Functional Balance, Coordination, and Mobility Measures Among Patients With Stable Chronic Obstructive Pulmonary Disease

Journal of Cardiopulmonary Rehabilitation ◽

10.1097/00008483-200407000-00013 ◽

2004 ◽

Vol 24 (4) ◽

pp. 274-280 ◽

Cited By ~ 91

Author(s):

Scott J. Butcher ◽

Jaclyn M. Meshke ◽

M. Suzanne Sheppard

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Functional Balance

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Jianpi Huatan Tongfu granule alleviates inflammation and improves intestinal flora in patients with acute exacerbation of chronic obstructive pulmonary disease

Journal of International Medical Research ◽

10.1177/0300060520909235 ◽

2020 ◽

Vol 48 (4) ◽

pp. 030006052090923

Author(s):

Wenxing Yong ◽

Liying Zhang ◽

Yuexuan Chen ◽

Juan Li ◽

Yongqi Liu ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Medical Treatment ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Therapeutic Efficacy ◽

Intestinal Flora ◽

Chronic Obstructive ◽

Integrative Treatment ◽

Obstructive Pulmonary Disease ◽

Healthy Participants

Objectives To investigate the clinical efficacy and mechanism of Jianpi Huatan Tongfu granule in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Sixty patients with AECOPD were enrolled in either of two groups: integrative treatment (Western medicine combined with Jianpi Huatan Tongfu granule) (n = 30) and Western medical treatment (n = 30). Thirty healthy individuals were included in the control group. Results Compared with healthy participants, patients with AECOPD had elevated clinical symptom and dyspnea severity scores. Patients with AECOPD had worsened lung function, compared with healthy participants. The therapeutic efficacy for integrative treatment was superior to Western medical treatment. Inflammatory proteins and cytokines were significantly elevated in patients with AECOPD, including C-reactive protein, interleukin-6, interleukin-8, and tumor necrosis factor-α; these were alleviated by both treatments, with more obvious effects for integrative treatment. Integrative treatment significantly changed the intestinal flora in patients with AECOPD, reaching levels comparable with those of healthy participants. Firmicutes abundance was significantly higher in healthy participants, whereas Bacteroidetes abundance was significantly higher in patients with AECOPD. After treatment, Verrucomicrobia abundance was significantly reduced in patients with AECOPD. Conclusion Jianpi Huatan Tongfu granule could alleviate inflammatory responses and improve clinical therapeutic efficacy in patients with AECOPD.

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