scholarly journals Pain in patients with chronic obstructive pulmonary disease indicated for post-acute pulmonary rehabilitation

2018 ◽  
Vol 16 ◽  
pp. 147997231880945 ◽  
Author(s):  
Eléonore F van Dam van Isselt ◽  
Karin H Groenewegen-Sipkema ◽  
Monica van Eijk ◽  
Niels H Chavannes ◽  
Wilco P Achterberg
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Status ◽  
Functional Status ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Functional Domain ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease

Pain is a significant problem in stable chronic obstructive pulmonary disease (COPD) and is associated with other symptoms, worse health status and lower functional status. Not much is known about pain in unstable disease. The primary aim of the present study is to investigate prevalence, characteristics and relationships of pain in patients with COPD hospitalized for an acute exacerbation (AECOPD) and indicated for post-acute pulmonary rehabilitation (PR). This cross-sectional observational study included 149 patients (mean age 70.8 (±7.9) years, 49% male, mean forced expiratory volume in one second as percentage of predicted value 35.3 (±12.6)). Pain was assessed using the brief pain inventory. Functional status and health status were measured using the six-minute walking test (6MWT), the Barthel index (BI) and the clinical COPD questionnaire (CCQ), respectively. Pain was prevalent in 39.6% of all patients. Symptom burden was high, especially in patients with pain. Although we found no difference in objective measurements of functional status (6MWT, BI), patients with pain had clinically relevant lower health status (CCQ), attributed to the functional domain. Pain in patients hospitalized for AECOPD and indicated for post-acute PR is a relevant problem and needs more attention. Incorporation of standard pain assessment during exacerbations and post-acute PR is recommended.

scholarly journals Impact of feedback on physical activity levels of individuals with chronic obstructive pulmonary disease during pulmonary rehabilitation

2014 ◽  
Vol 11 (4) ◽  
pp. 191-198 ◽  
Author(s):  
Joana Cruz ◽  
Dina Brooks ◽  
Alda Marques
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Activity Monitors ◽  
Standing Time ◽  
The Impact

This study aimed at investigating whether providing feedback on physical activity (PA) levels to patients with chronic obstructive pulmonary disease (COPD) is feasible and enhances daily PA during pulmonary rehabilitation (PR). Patients with COPD participated in a 12-week PR program. Daily PA was measured using activity monitors on weeks 1, 7, and 12, and feedback was given in the following weeks on the number of steps, time spent in sedentary, light, and moderate-to-vigorous intensity activities, and time spent standing, sitting, and lying. Compliance with PA monitoring was collected. Two focus groups were conducted to obtain patients’ perspectives on the use of activity monitors and on the feedback given. Differences in PA data were also assessed. Sixteen patients (65.63 ± 10.57 years; forced expiratory volume in one second (FEV1) 70.31 ± 22.74% predicted) completed the study. From those, only eleven participants used the activity monitors during all monitoring days. Participants identified several problems regarding the use of activity monitors and monitoring duration. Daily steps (  p = 0.026) and standing time (  p = 0.030) were improved from week 1 to week 7; however, the former declined from week 7 to week 12. Findings suggest that using feedback to improve PA during PR is feasible and results in improved daily steps and standing time on week 7. The subsequent decline suggests that additional strategies may be needed to stimulate/maintain PA improvements. Further research with more robust designs is needed to investigate the impact of feedback on patients’ daily PA.

scholarly journals ENDOTHELIAL DYSFUNCTION IN STABLE ANGINA AND MYOCARDIAL INFARCTION COMBINED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2015 ◽  
Vol 14 (6) ◽  
pp. 68-74 ◽  
Author(s):  
M. A. Popova ◽  
N. N. Terentyeva ◽  
D. A. Dolgopolova ◽  
T. V. Marenina
Keyword(s):  
Myocardial Infarction ◽  
Chronic Obstructive Pulmonary Disease ◽  
Endothelial Dysfunction ◽  
Pulmonary Disease ◽  
Stable Angina ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Brachial Artery Diameter ◽  
Obstructive Pulmonary Disease

The research objective is to determine the state of endothelium-dependent and endothelium-independent vasodilatation in patients with coronary heart disease (CHD) associated with chronic obstructive pulmonary disease (COPD).Material and methods. In the cross-sectional study included 122 patients with CHD associated with COPD: 68 people of them are patients with stable angina without acute coronary events in history and 54 patients with acute ST segment elevation myocardial infarction (STEMI). Comparison group comprised 53 patients with stable angina and 51 patients after STEMI without concomitant COPD. Patients were included if they met the following inclusion criteria: male, age <60 years, verified forms of CHD (stable angina, STEMI), documented with COPD without exacerbation and forced expiratory volume in 1 second > 30% in the groups with CHD and COPD. Arterial endothelial function was tested with high-resolution ultrasonography: brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation), and after administration of sublingual nitroglycerin (an endothelium-independent dilator).Results. We found that endothelial dysfunction in patients with acute and chronic forms of CHD in combination with COPD are more pronounced than in isolated CHD.Conclusion. Expressed depression functional vascular reserve in patients with CHD associated with COPD, should be taken into account when conducting individualized therapy of these patients.

scholarly journals Diaphragmatic Excursion is Correlated With the Improvement in Exercise Tolerance After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Masashi Shiraishi ◽  
Yuji Higashimoto ◽  
Ryuji Sugiya ◽  
Hiroki Mizusawa ◽  
Yu Takeda ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Roc Curve ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Maximum Level ◽  
Quadriceps Muscle ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Background: In patients with chronic obstructive pulmonary disease (COPD), the maximum level of diaphragm excursion (DEmax) is correlated with dynamic lung hyperinflation and exercise tolerance. This study aims to clarify the utility of DEmax to predict the improvement in exercise tolerance after pulmonary rehabilitation (PR) in patients with COPD.Methods: This was a prospective cohort study. Sixty-two patients with stable COPD participated in an outpatient PR programme from April 2018 to February 2021, and 50 completed the programme. Six-minute walk distance (6MWD) was used to evaluate exercise tolerance, and ultrasonography was used to measure DEmax. Responders to PR in exercise capacity were defined as patients with an increase >30 m in 6MWD. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of DEmax to predict responses to PR.Results: Baseline levels of forced expiratory volume in one second (%FEV1), 6MWD, maximum inspiratory pressure (PImax), DEmax and quadriceps muscle strength (QMS) were significantly higher, and peak dyspnoea of modified Borg (mBorg) scale was lower in responders (n = 30) than in non-responders (n = 20) to PR (p < 0.01). In multivariate analysis, DEmax was significantly correlated with an increase of >30 m in 6MWD. The area under the ROC curve of DEmax to predict responders was 0.915, with a sensitivity of 83% and a specificity of 95% at a cut-off point of 44.9 mm of DEmax.Conclusion: DEmax well predicted the improvement in exercise tolerance after PR in patients with COPD.

Gastroesophageal Reflux Disease in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 17 (1) ◽  
pp. 71-74
Author(s):  
Shahzad Hafeez ◽  
Ambreen Butt ◽  
Azhar Hussain ◽  
Muhammad Adnan Hashim ◽  
Sana Ahmad ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Pulmonary Disease ◽  
Reflux Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Chronic Obstructive Pulmonary Disorder ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease

Objective: To determine the frequency of gastroesophageal reflux disease (GERD) in patients with chronic obstructive pulmonary disease in our population Methodology: This cross-sectional study was conducted at medical out-patient Department, Services Hospital, Lahore; from September 2014 to March 2015. All the patients having chronic obstructive pulmonary disorder (COPD) were included. COPD was defined as the patients having a ratio of “forced expiratory volume in one second” (FEVI) to “forced vital capacity” (FVC) below 70% and having no improvement in FEVI after bronchodilator. Severity GERD was categorized as per episodes of symptoms. Information regarding the frequency of GERD was collected via study proforma. Data was analyzed using SPSS version 16.  Results:  Overall 100 cases were studied; their mean age was 47.54+3.62 years. Out of all 90% were males and 10% were females. Frequency of GERD in patients with COPD reveals 33%, followed by 03% study subjects had mild GERD, 7% had moderate, 11% had severe and 12% had very severe symptoms of GERD, while 67% had no nay symptoms of GERD. Conclusion: In the conclusion the frequency of gastroesophageal reflux disease (GERD) was found to be 33.0% among COPD subjects.  

Objectively Measured Steps/Day in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 13 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
Travis Saunders ◽  
Nerissa Campbell ◽  
Timothy Jason ◽  
Gail Dechman ◽  
Paul Hernandez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Activity Level ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Objectively Measured

Background:Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized.Methods:MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex).Results:38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates.Conclusions:These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level.

scholarly journals Six Minute Walk Distance Is a Predictor of Survival in Patients with Chronic Obstructive Pulmonary Disease Undergoing Pulmonary Rehabilitation

2015 ◽  
Vol 22 (4) ◽  
pp. 225-229 ◽  
Author(s):  
Esther Dajczman ◽  
Rima Wardini ◽  
Goulnar Kasymjanova ◽  
David Préfontaine ◽  
Marc Alexander Baltzan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Retrospective Chart Review ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Walk Distance ◽  
Obstructive Pulmonary Disease ◽  
Minimal Improvement ◽  
Severe Copd

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressive and distressing disease with a trajectory that is often difficult to predict.OBJECTIVE: To determine whether initial 6 min walk distance (6MWD) or change in 6MWD following inpatient pulmonary rehabilitation (PR) predicted survival.METHODS: Patients referred for PR in 2010 were studied in a retrospective chart review. Measures of 6MWD before and following PR were recorded. Initial 6MWD was categorized as ≥250 m, 150 m to 249 m and ≤149 m. Government databases provided survival status up until December 2013 and survival analyses were performed. Initial 6MWD and a minimally important difference (MID) of ≥30 m were used for survival analysis.RESULTS: The cohort consisted of 237 patients (92 men, 145 women) with severe COPD. Mean (± SD) forced expiratory volume in 1 s (FEV1) was 0.75±0.36 L, with a mean FEV1/forced vital capacity (FVC) ratio of 0.57±0.16. Overall three-year survival was 58%. Mean survival for the study period as per predefined categories of 6MWD of ≥250 m, 150 m to 249 m and ≤149 m was 42.2, 37.0 and 27.8 months (P<0.001), respectively, with a three-year survival of 81%, 66% and 34% observed, respectively. Overall mean change in 6MWD was 62±57 m, and a minimal improvement of ≥30 m was observed in 72% of patients. In the lowest walking group, early mortality was significantly higher among those who did not achieve minimal improvement. Older age, male sex and shorter initial 6MWD were negative predictors of survival.CONCLUSION: In patients with severe COPD, initial 6MWD was predictive of survival. Overall survival at three years was only 58% and was especially poor (34%) in patients with low (<150 m) initial walk distance.

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