scholarly journals Supervised pulmonary rehabilitation using minimal or specialist exercise equipment in COPD: a propensity-matched analysis

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215281
Author(s):  
Suhani Patel ◽  
Melanie D Palmer ◽  
Claire Marie Nolan ◽  
Ruth Emily Barker ◽  
Jessica Anne Walsh ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Low Cost ◽  
Chronic Respiratory Disease ◽  
Control Group ◽  
Chronic Respiratory Disease Questionnaire ◽  
Cycle Ergometers ◽  
Related Quality ◽  
Health Related ◽  
Clinically Significant ◽  
Exercise Equipment

BackgroundMany trials supporting the benefits of pulmonary rehabilitation (PR) have used specialist exercise equipment, such as treadmills and cycle ergometers. However, access to specialist equipment may not be feasible in some settings. There is growing interest in delivering PR programmes with minimal, low-cost equipment, but uncertainty remains regarding their efficacy compared with programmes using specialist equipment.MethodsUsing propensity score matching, 318 consecutive patients with COPD undergoing supervised PR using minimal equipment (PR-min) were compared 1:1 with a control group of 318 patients with COPD who underwent supervised PR using specialist equipment (PR-gym). A non-inferiority analysis was performed for the primary outcome (incremental shuttle walk (ISW)) and secondary outcomes (Chronic Respiratory Disease Questionnaire (CRQ)—domain and total scores).ResultsSimilar improvements in ISW and CRQ-domains were observed in PR-min and PR-gym groups (mean difference ISW: 3 m (95% CI −16 to 9); CRQ-total: 0.9 (95% CI −2.7 to 4.5)). The 95% CI between group differences for ISW and CRQ-total did not cross the predefined non-inferiority margins. However, completion rates were lower in PR-min compared with PR-gym (64% vs 73%; p=0.014).ConclusionsIn patients with COPD, PR delivered using minimal equipment produces clinically significant benefits in exercise capacity and health-related quality of life that are non-inferior to rehabilitation delivered using specialist equipment. This study provides support for the provision of PR using minimal exercise equipment, particularly in areas where access to specialist exercise equipment is limited.

scholarly journals Pulmonary rehabilitation in bronchiectasis: a propensity-matched study

2018 ◽  
Vol 53 (1) ◽  
pp. 1801264 ◽  
Author(s):  
Suhani Patel ◽  
Aaron D. Cole ◽  
Claire M. Nolan ◽  
Ruth E. Barker ◽  
Sarah E. Jones ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Real Life ◽  
Chronic Respiratory Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Completion Rates ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Disease Questionnaire ◽  
Real Life Data ◽  
Matched Study

International guidelines recommend pulmonary rehabilitation for patients with bronchiectasis, supported by small trials and data extrapolated from chronic obstructive pulmonary disease (COPD). However, it is unknown whether real-life data on completion rates and response to pulmonary rehabilitation are similar between patients with bronchiectasis and COPD.Using propensity score matching, 213 consecutive patients with bronchiectasis referred for a supervised pulmonary rehabilitation programme were matched 1:1 with a control group of 213 patients with COPD. Completion rates, change in incremental shuttle walk (ISW) distance and change in Chronic Respiratory Disease Questionnaire (CRQ) score with pulmonary rehabilitation were compared between groups.Completion rate was the same in both groups (74%). Improvements in ISW distance and most domains of the CRQ with pulmonary rehabilitation were similar between the bronchiectasis and COPD groups (ISW distance: 70 versus 63 m; CRQ-Dyspnoea: 4.8 versus 5.3; CRQ-Emotional Function: 3.5 versus 4.6; CRQ-Mastery: 2.3 versus 2.9; all p>0.20). However, improvements in CRQ-Fatigue with pulmonary rehabilitation were greater in the COPD group (bronchiectasis 2.1 versus COPD 3.3; p=0.02).In a real-life, propensity-matched control study, patients with bronchiectasis show similar completion rates and improvements in exercise and health status outcomes as patients with COPD. This supports the routine clinical provision of pulmonary rehabilitation to patients with bronchiectasis.

scholarly journals Examining the efficacy of DVD technology in COPD self-management education of rural patients

2009 ◽  
Vol 7 (1) ◽  
pp. 26-42 ◽  
Author(s):  
Michael Stellefson ◽  
Beth H. Chaney ◽  
J. Don Chaney
Keyword(s):  
Information Needs ◽  
Management Education ◽  
Two Dimensions ◽  
Self Management ◽  
Health Clinic ◽  
Control Group ◽  
Multiple Group ◽  
Related Quality ◽  
Health Related ◽  
Clinically Significant

A pilot study (n = 41) was conducted to test the effects of three educational treatments (DVD vs. Pamphlet vs. DVD + Pamphlet) on health-related quality of life (HRQoL), COPD information needs and self-efficacy among a referred sample of Certified Federal Rural Health Clinic patients (mean age = 61.51 years ± 6.29 years; ~61% female) suffering from COPD using a randomly-assigned, multiple-group pretest-posttest design with a control group. A MANCOVA testing planned multivariate contrasts determined patients receiving a DVD reported statistically significant higher levels of lung-specific physical functioning as compared to patients receiving a Pamphlet. Additionally, DVD patients reported clinically significant improvements on two dimensions of lung-specific HRQoL. No such improvements occurred within the Pamphlet and Control groups. The provision of self-management education as compared to usual care, however, did not improve the outcome variables examined.

Oral Health-Related Quality of Life Among Sudanese Children Treated for Cleft Lip and Palate

2021 ◽  
pp. 105566562098769
Author(s):  
Mecheala Abbas Ali ◽  
Alwaleed Fadul Nasir ◽  
Shaza K. Abass
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Arabic Version ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Objective: This study compared the oral health-related quality of life (OHRQoL) among children with a cleft lip with or without a cleft palate (CL±P) and a group of their peers. The reliability of the Arabic version of the Child Oral Health Impact Profile Questionnaire (COHIP) was also assessed. Design: A cross-sectional study. Settings: Cleft clinic in a private dental college in Omdurman City, Sudan. Patients: In all, 75 children (mean age 11.3 ± 2.5 years) with a history of CL±P and a group of 150 school children without CL±P (mean age 11.4 ± 2.6 years). Main Outcome Measures: Overall and subscale scores on the Arabic version of the COHIP. Results: Test–retest reliability of COHIP in Arabic was high with an interclass correlation coefficient >0.8. Cronbach α value internal consistency was 0.8 for the total scale and between 0.7 and 0.8 for the subscales. The COHIP score was 89.41 ± 19.97 in children with CL±P and 122.82 ± 9.45 for the control group. Children with CL±P had significantly lower scores on the overall and all subscales when compared to children without CL±P ( P ≤ .001). Among the children with CL±P, there were no statistically significant differences on the COHIP based on age and/or gender ( P ≥ .05). Conclusions: Children with CL±P had a relatively high OHRQoL, which was lower than that of their peers without CL±P in both the overall scale and all subscales. Gender and age differences had no significant impact on the OHRQoL. The COHIP Arabic version showed appropriate reliability.

scholarly journals Health-Related Quality of Life and Related Factors in Persons with Preserved Ratio Impaired Spirometry: Data from the Korea National Health and Nutrition Examination Surve

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 4
Author(s):  
I Re Heo ◽  
Ho Cheol Kim ◽  
Tae Hoon Kim
Keyword(s):  
Quality Of Life ◽  
Low Income ◽  
Control Group ◽  
Poor Hrqol ◽  
Related Factors ◽  
Health And Nutrition ◽  
Prism Group ◽  
Related Quality ◽  
Health Related

Background and Objectives: preserved ratio impaired spirometry (PRISm) is a common spirometric pattern that causes respiratory symptoms, systemic inflammation, and mortality. However, its impact on health-related quality of life (HRQOL) and its associated factors remain unclear. We aimed to identify these HRQOL-related factors and investigate the differences in HROOL between persons with PRISm and those with normal lung function. Materials and Methods: we reviewed the Korea National Health and Nutrition Examination Survey data from 2008 to 2013 to evaluate the HRQOL of persons with PRISm, as measured while using the Euro Quality of Life-5D (EQ-5D) and identify any influencing factors. PRISm was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1) <80% predicted and FEV1 to forced vital capacity (FVC) ratio (FEV1/FVC) ≥0.7. Individuals with FEV1 ≥80% predicted and FEV1/FVC ≥0.7 were considered as Controls. Results: of the 27,824 participants over the age of 40 years, 1875 had PRISm. The age- and sex-adjusted EQ-5D index was lower in the PRISm group than in the control group (PRISm, 0.930; control, 0.941; p = 0.005). The participants with PRISm showed a significantly higher prevalence of hypertension (p < 0.001), diabetes (p < 0.001), obesity (p < 0.001), low physical activity (p = 0.001), ever-smoker (p < 0.001), and low income (p = 0.034) than those in the control group. In participants with PRISm, lower EQ-5D index scores were independently associated with old age (p = 0.002), low income (p < 0.001), low education level (p < 0.001), and no economic activity (p < 0.001). Three out of five EQ-5D dimensions (mobility, self-care, and usual activity) indicated a higher proportion of dissatisfied participants in the PRISm group than the control group. Conclusions: the participants with PRISm were identified to have poor HRQOL when compared to those without PRISm. Old age and low socioeconomic status play important roles in HRQOL deterioration in patients with PRISm. By analyzing risk factors that are associated with poor HRQOL, early detection and intervention of PRISm can be done in order to preserve patients’ quality of life.

scholarly journals Health-related quality of life and anxiety in the PAN-CAN lung cancer screening cohort

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024719 ◽  
Author(s):  
Niloofar Taghizadeh ◽  
Alain Tremblay ◽  
Sonya Cressman ◽  
Stuart Peacock ◽  
Annette M McWilliams ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Levels ◽  
Clinically Significant ◽  
Baseline Screening

ObjectivesThe impact of lung cancer screening with low-dose chest CT (LDCT) on participants’ anxiety levels and health-related quality of life (HRQoL) is an important consideration in the implementation of such programmes. We aimed to describe changes in anxiety and HRQoL in a high-risk Canadian cohort undergoing LDCT lung cancer screening.Methods2537 subjects who had 2% or greater lung cancer risk over 6 years using a risk prediction tool were recruited from eight centres across Canada in the Pan-Canadian Early Detection of Lung Cancer Study (2008–2010). We compared HRQoL and anxiety levels before and after screening of 1237 participants with LDCT (excluding a subset of 1300 participants who also underwent autofluorescence bronchoscopy screening), as well as after investigations performed because of a positive screening examination. The 12-item short-form Physical and Mental Component Scales (SF-12), EQ-5D-3L scores and State Trait Anxiety Inventory-State anxiety were used at each assessment.ResultsOverall, there were no clinically significant differences in HRQoL outcomes between baseline and each of the survey time points following initial screening. No mean change in anxiety in the overall cohort was noted following baseline LDCT, but more participants had clinically significant increase in anxiety versus decrease after baseline screening (increase >minimal clinically important difference (MCID) (n=180) vs decrease >MCID (n=50), p<0.001). This finding persisted but to a lesser degree at the 12 month time point (increase >MCID (n=146) vs decrease >MCID (n=87), p<0.001).ConclusionsCT screening for lung cancer has no major overall impact on HRQoL among participants, although a minority of participants (number-needed-to-harm=7 after baseline screening and 18 at 1 year) demonstrated clinically significant increased anxiety levels.Trialregistration numberNCT00751660; Results.

scholarly journals Short-term Efficacy of Upper-Extremity Exercise Training in Patients With Chronic Airway Obstruction: A Systematic Review

2009 ◽  
Vol 89 (5) ◽  
pp. 443-455 ◽  
Author(s):  
Stefania Costi ◽  
Mauro Di Bari ◽  
Paolo Pillastrini ◽  
Roberto D'Amico ◽  
Ernesto Crisafulli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Exercise Training ◽  
Pulmonary Rehabilitation ◽  
Health Related Quality ◽  
Inclusion Criteria ◽  
Patient Centered ◽  
Related Quality ◽  
Health Related

Background, Objectives, and Measurements Patients with chronic airway obstruction (CAO) frequently experience dyspnea and fatigue during activities performed by accessory muscles of ventilation, which competitively participate in arm elevation. This systematic review of randomized controlled trials (RCTs) concerning patients with CAO addresses the effects of upper-extremity exercise training (UEET), added to lower-extremity training or comprehensive pulmonary rehabilitation, on the following patient-centered outcomes: exercise capacity, symptoms, ability to perform daily activities, and health-related quality of life. Methods Studies were retrieved using comprehensive database and hand-search strategies. Two independent reviewers determined study eligibility based on inclusion criteria. A detailed description of treatments was mandatory. Reviewers rated study quality and extracted information on study methods, design, intervention, and results. Results Forty publications were evaluated. Four RCTs met the inclusion criteria but had serious methodological limitations, which introduce possible biases that reduce their internal validity. The outcomes measured were heterogeneous, and the results were inconsistent regarding maximal exercise capacity, dyspnea, and health-related quality of life. No effect of UEET was demonstrated for measures of arm fatigue. Limitations and Conclusions The limited methodological quality of the studies retrieved prevented us from performing a meta-analysis, the results of which could be misleading. This systematic review shows that there is limited evidence examining UEET and that the evidence available is of poor quality. Therefore, a recommendation for the inclusion or exclusion of UEET in pulmonary rehabilitation programs for individuals with CAO is not possible. Further research is needed to definitively ascertain the effects of this training modality on patient-centered outcomes.

Effectiveness of Teleassistance at Improving Quality of Life in People with Neuromuscular Diseases

2014 ◽  
Vol 17 ◽  
Author(s):  
Oscar Martínez ◽  
Amaia Jometón ◽  
Manuel Pérez ◽  
Esther Lázaro ◽  
Imanol Amayra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Interaction ◽  
New Technologies ◽  
Neuromuscular Diseases ◽  
Control Group ◽  
Related Quality ◽  
Health Related ◽  
Low Prevalence ◽  
Psychosocial Domain

AbstractRare neuromuscular diseases (NDs) are a group of inherited or acquired neurological pathologies affecting the muscles and the nervous system. Their low prevalence and high geographical dispersion can cause isolation and difficulties in social interaction between affected equals. New technologies, such as videoconferencing, offer a complementary option for improving the health of this population. The purpose of this study was to assess the effectiveness of a teleassistance program at improving health-related quality of life (HRQoL) through social interaction in adults with NDs. The sample consisted of 45 participants affected by rare NDs. Twenty-four participants were assigned to the experimental group (EG), which participated in the videoconferencing sessions, and 21 to the control group. Three questionnaires were administered: WHO-DAS II, Sickness Impact Profile, and SF-36 Health Survey. Effectiveness was assessed by a pre-post design. An online psychosocial program was applied over three-month period. Data revealed an improvement of the EG in psychosocial variables, e.g. “Getting along with people” (z = –2.289, r = –.47, p ≤ .05) or “Psychosocial Domain” (z = –2.404, r = –.49, p ≤ .05), and in physical variables, e.g. “Life activities” (z = –2.844, r = –.58, p ≤ .05). Social interaction appeared as a relevant factor at improving HRQoL levels. High levels of satisfaction about the teleassistance program were reported.

scholarly journals Reduction in hospitalisation following pulmonary rehabilitation in patients with COPD

2008 ◽  
Vol 32 (3) ◽  
pp. 415 ◽  
Author(s):  
Nola Cecins ◽  
Elizabeth Geelhoed ◽  
Sue C Jenkins
Keyword(s):  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Hospital Admissions ◽  
Chronic Respiratory Disease ◽  
Health Care Utilisation ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Chronic Respiratory Disease Questionnaire ◽  
Number Of Patients ◽  
Bed Days

Objectives: Pulmonary rehabilitation (PR) improves exercise capacity and health-related quality of life (HRQoL), and reduces health care utilisation. This study quantified outcomes of a PR program over a 6-year period and determined the effects of PR on hospitalisation. Methods: Patients with chronic obstructive pulmonary disesae (COPD) who entered an 8-week outpatient PR program from 1998 to 2003 were included. Functional exercise capacity (6-minute walk distance [6MWD]) and HRQoL (Chronic Respiratory Disease Questionnaire) were measured before and following PR. The number of hospital admissions and total bed-days due to a COPD exacerbation in the 12 months before and following PR were recorded. Setting: Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia. Results: 187 (73%) of the 256 patients who entered PR completed the program. Improvements in 6MWD (404.2 �114.6 m to 439.6 �115.0m, P < 0.001) and HRQoL (4.1 �0.9 points per item to 4.9 �0.9 points per item, P < 0.001) occurred following PR. There was a 46% reduction in the number of patients admitted to hospital (71 to 38) with a COPD exacerbation and a 62% reduction in total bed-days (1131 to 432) following PR. Conclusion: Pulmonary rehabilitation provided in an Australian teaching hospital was associated with a reduction in COPD hospitalisation, and the resultant savings outweighed the costs of providing the program.

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