Benefits of a Multidisciplinary Pulmonary Rehabilitation Program. Improvements are Independent of Lung Function

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.

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

10.21203/rs.3.rs-1192916/v1 ◽

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.

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

Home Health Care Management & Practice ◽

10.1177/1084822321990376 ◽

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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