scholarly journals Oral prednisolone for 4 days does not increase exercise tolerance in men with COPD

2017 ◽  
Vol 15 (2) ◽  
pp. 220-222
Author(s):  
SL Karlsson ◽  
V Backer ◽  
Nina Skavlan Godtfredsen
Keyword(s):  
Lung Function ◽  
Controlled Trial ◽  
Maximum Voluntary Contraction ◽  
Oral Prednisolone ◽  
Voluntary Contraction ◽  
Annual Number ◽  
Chronic Obstructive ◽  
Time To Exhaustion ◽  
Obstructive Pulmonary Disease ◽  
Muscle Groups

One of the primary objectives in management of chronic obstructive pulmonary disease (COPD) is preventing decrease in lung function and reducing the annual number of acute exacerbations of COPD (AECOPD). An oral course of systemic corticosteroids is a commonly used treatment in AECOPD. We hypothesize that this treatment also increases exercise performance and decreases muscle fatigue. In a randomized double-blinded, parallel, placebo-controlled trial, we investigated 14 men (8 on prednisolone 37.5 mg vs. 6 on placebo) with severe and very severe COPD. For 5 consecutive days, the patients performed a submaximal endurance test measuring time to exhaustion (TTE, primary endpoint), spirometry, maximal inspiratory and expiratory pressure and maximal isometric contraction of the quadriceps femoris muscle (maximum voluntary contraction (MVC)). At visits 2, 3 and 4, a fatigue protocol was carried out after 40 minutes of cycling at 40% of maximal effort. No differences between groups were found for TTE, lung function or maximal inspiratory or expiratory pressure, however, patients on prednisolone showed significant increased MVC: median 5.15 [3.35; 9.15] against placebo: −2 [−5.57; 3.95] ( p = 0.03). This finding indicates an impact of corticosteroids on muscle groups being exposed to submaximal endurance.

Barriers for recruitment of patients with chronic obstructive pulmonary disease to a controlled telemedicine trial

2016 ◽  
Vol 24 (2) ◽  
pp. 216-224 ◽  
Author(s):  
Eva Broendum ◽  
Charlotte Suppli Ulrik ◽  
Thorbjorn Gregersen ◽  
Ejvind Frausing Hansen ◽  
Allan Green ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Mass Index ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Controlled Trial ◽  
Admission Rate ◽  
Chronic Obstructive ◽  
Lower Body ◽  
Obstructive Pulmonary Disease ◽  
Tailored Approach

The aim of this analysis is to investigate reasons why patients with chronic obstructive pulmonary disease decline to participate in a controlled trial of telemedicine. Patients with previous chronic obstructive pulmonary disease exacerbations were invited to participate in a 6-month randomized telemedicine trial. For eligible patients, reasons for refusal were registered. Of 560 eligible patients, 279 (50%) declined to participate in the trial, 257 (92%) reported a reason: 53 (20.6%) technical concerns, 164 (63.8%) personal reasons, 17 (6.6%) preferred outpatient clinic visits, and 23 (8.9%) did not want to participate in clinical research. Compared to consenting patients, subjects declining participation were significantly older, more often female, had higher lung function (%predicted), lower body mass index, higher admission-rate for chronic obstructive pulmonary disease in the previous year, and were more often diagnosed with osteoporosis. Many eligible patients decline participating in a controlled tele-healthcare trial and, furthermore, a tailored approach for recruiting females and elderly patients appears appropriate.

scholarly journals A Randomized Controlled Trial to Assess the Efficacy of Tiotropium in Canadian Patients with Chronic Obstructive Pulmonary Disease

2007 ◽  
Vol 14 (8) ◽  
pp. 465-472 ◽  
Author(s):  
Charles KN Chan ◽  
François Maltais ◽  
Chris Sigouin ◽  
Jennifer M Haddon ◽  
Gordon T Ford ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Double Blind ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) who smoke have a greater annual rate of decline in forced expiratory volume in 1 s (FEV1) than those patients who have stopped smoking.OBJECTIVES: To assess the effect of tiotropium on pre-dose (trough) FEV1in patients with COPD followed in Canada.METHODS: A total of 913 patients were randomly assigned to receive either tiotropium 18 μg once daily (n=608) or placebo (usual care minus inhaled anticholinergics) (n=305) for 48 weeks in the present randomized, double-blind, parallel-group study. The effect of tiotropium on measurements of lung function (FEV1, FEV6and forced vital capacity), symptoms, health-related quality of life (St George’s Respiratory Questionnaire) and exacerbations were examined.RESULTS: Tiotropium improved trough FEV1in both current and ex-smokers compared with placebo. Baseline FEV1in smokers and ex-smokers was 1.03 L and 0.93 L, respectively (P<0.001). At week 48, the mean difference between the tiotropium and placebo groups was 0.14±0.04 L (P<0.001) in the smoker group and 0.08±0.02 L (P<0.0001) in the ex-smoker group. Tiotropium also significantly improved trough forced vital capacity and FEV6compared with placebo throughout the treatment period (P<0.05, for all). Furthermore, tiotropium significantly improved the St George’s Respiratory Questionnaire total score compared with placebo at week 48 (40.9 versus 43.7 units, P<0.005).CONCLUSIONS: Compared with the placebo group, tiotropium provides sustained improvements in lung function in patients with COPD, with improvements for smokers and ex-smokers.

scholarly journals The use of ultrasonography as a tool to evaluate the quadriceps muscle in patients with chronic obstructive pulmonary disease: a systematic review

2022 ◽  
Vol 11 (1) ◽  
pp. e19911124728
Author(s):  
Thais Angélica Bobalo dos Santos ◽  
Paula Motta dos Santos ◽  
Talita Wassmuth ◽  
Débora Melo Mazzo ◽  
Bruno Margueritte Costa ◽  
...  
Keyword(s):  
Low Cost ◽  
Maximum Voluntary Contraction ◽  
Quadriceps Muscle ◽  
Voluntary Contraction ◽  
Chronic Obstructive ◽  
Inclusion Criteria ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Muscle ◽  
Section Area ◽  
Potential Clinical Utility

Abstract: The aim of this review is to understand the feasibility and potential clinical utility of US in measurements of the quadriceps muscles in patients with COPD. A total of 217 studies were identified and after applying the inclusion criteria, 12 were selected. The data were systematically searched by two independent reviewers. Of the included articles, five evaluated the maximal voluntary contraction of the quadriceps muscle and the Transverse Section Area (TSA) measured by US, of these, 4 found a remarkably reduced strength in COPD and in one article, it was described that this reduction occurs in all grades of the disease. Moreover, the greater the thickness of the quadriceps, the greater the maximum voluntary contraction of this musculature, however, the TSA is reduced in these patients when compared to healthy individuals. Thus, it is suggested that the AST, evaluated by US, can be used to assess the presence and/or severity of musculoskeletal dysfunction in these patients. The sonographic evaluation of the quadriceps in patients with COPD may provide a safe, effective, low-cost, reliable and reproducible evaluation, allowing the identification and monitoring of peripheral muscle dysfunction in this population, even when compared with other strategies.

scholarly journals Physical activity and exercise capacity in patients with moderate COPD exacerbations

2016 ◽  
Vol 48 (2) ◽  
pp. 340-349 ◽  
Author(s):  
Ayedh D. Alahmari ◽  
Beverly S. Kowlessar ◽  
Anant R.C. Patel ◽  
Alex J. Mackay ◽  
James P. Allinson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Capacity ◽  
Maximum Voluntary Contraction ◽  
Normal Activity ◽  
Voluntary Contraction ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Similar Time ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations

Little is known about changes in physical activity during moderate (out-patient managed) exacerbations.6-min walking distance (6MWD) was measured during 50 exacerbations when the patients were stable, and at 3 and 7 days post-exacerbation presentation. At similar time points, quadriceps maximum voluntary contraction (QMVC) was measured during 47 different exacerbations. Physical activity (SenseWear; Bodymedia Inc., Pittsburgh, PA, USA) was recorded over 2 consecutive-week periods post-presentation.6MWD fell from a median 422 m when stable to 373 m on day 3 (p=0.001). Similarly, QMVC fell from 32.6 versus 29.7 kg (p=0.026). Falls in 6MWD were associated with a rise in C-reactive protein (r= −0.364; p=0.041) and increased Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) (r= −0.44; p=0.013). Light physical activity was 2.18 h·day−1 during the first week post-exacerbation and was less over week 2 (1.98 h·day−1; p=0.009). Patients who had attended pulmonary rehabilitation had smaller changes in 6MWD than those who had not attended (−35.0 versus −114.9 m; p=0.013). Falls in physical activity were correlated with higher depression scores (rho= −0.51; p=0.006).These findings indicate that exercise capacity and muscle strength fall at exacerbation in chronic obstructive pulmonary disease patients who are treated at home and are free to maintain normal activity.

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