scholarly journals CORRELATION BETWEEN DIAPHRAGM EXCURSION WITH BOTH THE QUALITY OF LIFE AND EXERCISE CAPACITY FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE STUDIED BY ULTRASOUND

Author(s):  
PENG AN ◽  
PING QIN ◽  
JIANRU WANG ◽  
HE RONG ZHOU

Objective: To study the correlation between diaphragm excursion and both the quality of life and exercise capacity in patients with chronic obstructive pulmonary disease (COPD) by ultrasound and to reveal the factors affecting diaphragm excursion. Methods: A total of 42 COPD patients who were treated in our hospital from October 2015 to March 2020 and 42 healthy volunteers (control group) were included in the present study. The participants’ height, weight, and diaphragm excursion (the amplitude of diaphragm movement during deep breathing measured by M-mode ultrasound ([Formula: see text])), diaphragm movement time, degree of airflow obstruction (the forced expiratory volume in one second (FEV1) as a percentage of its predicted level, FEV1%pred), and exercise capacity (six-minute walk distance, 6MWD) were measured. The St. George’s Respiratory Questionnaire (SGRQ) was used to evaluate the patients’ quality of life. The correlation between the amplitude of diaphragm movement and lung function was analyzed. The receiver operating characteristics (ROC) curve was used to determine the COPD diagnosis efficacy of M-mode ultrasound, and its influencing factors were further analyzed. Results: During tidal breathing, the movement amplitudes of both hemidiaphragms in the COPD group were greater than those in the control group. During deep breathing, the movement amplitudes of both hemidiaphragms in the control group were greater than those in the COPD group. Moreover, during both tidal and deep breathing, the movement time of the right hemidiaphragm in the control group was longer than that in the COPD group (all [Formula: see text]). During deep breathing, the amplitude of diaphragm movement was positively correlated with FEV1 and FEV1%pred (both [Formula: see text]). During both tidal and deep breathing, the area under the ROC curve (AUC) for the diagnosis of COPD according to the diaphragm movement amplitude was 0.833 and 0.887, respectively, and the AUC for the diagnosis of COPD according to the diaphragm movement time was 0.625 and 0.732, respectively. The [Formula: see text] was correlated with the SGRQ score, symptom score, impact score, activity score, and 6MWD, with correlation coefficients of [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and 0.536, respectively. The factors affecting the [Formula: see text] were height ([Formula: see text], [Formula: see text]) and FEV1%pred ([Formula: see text], [Formula: see text]). Conclusion: The diaphragm excursion in COPD was closely related to patients’ quality of life. Height and FEV1%pred had the greatest impact on diaphragm excursion. The lower the diaphragm excursion of the patient, the worse their quality of life and the lower their exercise capacity.

Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.


2020 ◽  
Vol 74 (2) ◽  
pp. 91-94
Author(s):  
S.V. Turkina ◽  
◽  
A.A. Grishchenko ◽  
N.I. Zhernakova ◽  
T.Yu. Lebedev ◽  
...  

40 elderly and senile patients were examined including 20 patients with exacerbation of chronic obstructive pulmonary disease (COPD) of moderate severity (experimental group) and 20 cases without COPD, acute diseases and exacerbations of chronic pathology (control group). Impact of COPD was studied for various aspects of quality of life. It was analyzed the nature and strength of the relationship between of quality of life indicators and biochemical survey results.


2011 ◽  
Vol 18 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Michael K Stickland ◽  
Tina Jourdain ◽  
Eric YL Wong ◽  
Wendy M Rodgers ◽  
Nicholas G Jendzjowsky ◽  
...  

BACKGROUND: Pulmonary rehabilitation (PR) is an effective therapeutic strategy to improve health outcomes in patients with chronic obstructive pulmonary disease (COPD); however, there is insufficient PR capacity to service all COPD patients, thus necessitating creative solutions to increase the availability of PR.OBJECTIVE: To examine the efficacy of PR delivered via Telehealth (Telehealth-PR) compared with PR delivered in person through a standard outpatient hospital-based program (Standard-PR).METHODS: One hundred forty-seven COPD patients participated in an eight-week rural PR program delivered via Telehealth-PR. Data were compared with a parallel group of 262 COPD patients who attended Standard-PR. Education sessions were administered two days per week via Telehealth, and patients exercised at their satellite centre under direct supervision. Standard-PR patients viewed the same education sessions in person and exercised at the main PR site. The primary outcome measure was change in quality of life as evaluated by the St George’s Respiratory Questionnaire (SGRQ). A noninferiority analysis was performed using both intention-to-treat and per-protocol approaches.RESULTS: Both Telehealth-PR and Standard-PR resulted in clinically and statistically significant improvements in SGRQ scores (4.5±0.8% versus 4.1±0.6%; P<0.05 versus baseline for both groups), and the improvement in SGRQ was not different between the two programs. Similarly, exercise capacity, as assessed by 12 min walk test, improved equally in both Telehealth-PR and Standard-PR programs (81±10 m versus 82±10 m; P<0.05 versus baseline for both groups).CONCLUSION: Telehealth-PR was an effective tool for increasing COPD PR services, and demonstrated improvements in quality of life and exercise capacity comparable with Standard-PR.


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