Cell Therapy in Patients with Advanced Chronic Obstructive Pulmonary Disease: 3 and 6 months follow up of Six Minute Walk Test, Quality of life and Pulmonary Function

Abstract Background Handheld oscillating positive expiratory pressure (OPEP) devices have been a mainstay of treatment for patients with hypersecretory conditions such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) since the 1970s. Current devices are reusable and require regular cleaning and disinfection to prevent harbouring potentially pathogenic organisms. Adherence to cleaning regimens for respiratory devices is often poor and in response to this, a prototype disposable OPEP device—the ‘UL-OPEP’ (University of Limerick—Oscillating Positive Expiratory Pressure device)—was developed to mitigate the risk of contamination by pathogens. The device was previously evaluated successfully in a group of paediatric CF patients. The aim of the current study was to initially evaluate the safety of the prototype in patients with COPD over a period of 1 month to ensure no adverse events, negative impacts on lung function, exercise tolerance, or quality of life. Data on user experience of the device were also collected during post-study follow-up. Methods A sample of 50 volunteer participants were recruited from pulmonary rehabilitation clinics within the local hospital network. The patients were clinically stable, productive, and not current or previous users of OPEP devices. Participants were invited to use a prototype disposable OPEP device daily for a period of 1 month. Pre- and post-study lung function was assessed with standard spirometry, and exercise tolerance with the 6-min-walk-test (6MWT). Quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ), and user experience of the prototype device evaluated using a post-study questionnaire. Results 24 Participants completed the study: 9 were female. Overall median age was 67.5 years, range 53–85 years. Lung function, 6-min walk test, and SGRQ scores showed no significant change post-study. User feedback was positive overall. Conclusions The results indicate that the UL-OPEP is safe to use in patients with COPD. No adverse events were recorded during the study or in the follow-up period of 2 weeks. The device did not negatively impact patients’ lung function, exercise tolerance, or quality of life during short term use (1 month), and usability feedback received was generally positive. Larger, longer duration studies will be required to evaluate efficacy. Registration The study was approved as a Clinical Investigation by the Irish Health Products Regulatory Authority (CRN-2209025-CI0085).

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EFFECT OF PULMONARY REHABILITATION IN PATIENTS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A HOSPITAL BASED CROSS SECTIONAL STUDY

10.36106/gjra/8700545 ◽

2020 ◽

pp. 1-4

Author(s):

Ashish Kumar Dubey ◽

Ravi Shankar Mishra*

Keyword(s):

Quality Of Life ◽

Chronic Obstructive Pulmonary Disease ◽

Statistical Analysis ◽

Pulmonary Rehabilitation ◽

Chronic Obstructive ◽

Walk Test ◽

Borg Scale ◽

Obstructive Pulmonary Disease

BACKGROUND: Chronic obstructive pulmonary disease(COPD) is an obstructive and progressive airway disease associated with reduction in daily physical activity and psychological problems related to patient's disability and poor quality of life. Pulmonary rehabilitation(PR) plays an essential role in the management of COPD, by breaking the vicious circle of dyspnea–decreased activity–deconditioning–isolation. AIM: This study aimed to highlight the impact of PR on COPD patients while focusing on the clinical usefulness of PR. MATERIALS & METHODS: This study was done over a period of 1.5 years including all the diagnosed cases of COPD (both OPD and IPD) who did not have any acute exacerbation requiring oxygen, not associated with other medical conditions such as heart disease, neurological disease, lumbar spondylitis or osteoarthritis or those unable to perform PFT after taking proper consent. The study was completed with a follow up schedule, monthly, for 3 months. Proforma for the study included demographics, history, examination, dyspnea grading using modied Borg scale as well as CAT questionnaire along with a six-minute walk test and spirometry. Statistical analysis was done using SPSS Version 20 (Chicago Inc., USA). Data comparison was done by applying specic statistical tests to nd out the statistical signicance of the comparisons. Quantitative variables were compared using mean values and qualitative variables using proportions. Signicance level was xed at P < 0.05. RESULTS: Out of total 227 cases, only 71 completed the 3-month monthly follow up and hence were used for the statistical analysis. The results showed male:female ratio 80.3:19.7. As per Borg scale, mean fever, chest pain, cough, expectoration and dyspnea score decreased over subsequent follow-up. Rate of hospitalisation was seen more in 61-70 year age group. Mean sixminute walk test value increased continuously during the duration of follow up. CONCLUSION: Effective pulmonary rehabilitation that incorporates exercise schedules and patient education compreh ensively can encompass treatment and improve the quality of life of patients suffering with COPD.

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Faculty Opinions recommendation of Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717979811.793475671 ◽

2013 ◽

Author(s):

Roberto Rodriguez-Roisin ◽

Ebymar Arismendi Núñez

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Minimal Clinically Important Difference ◽

Chronic Obstructive ◽

Walk Test ◽

Obstructive Pulmonary Disease ◽

Six Minute Walk Test ◽

Clinically Important Difference ◽

Minute Walk

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P1499Trend of end-tidal pressure of carbon dioxide in patients with chronic heart failure and chronic obstructive pulmonary disease during six minute walk test and monitoring

European Heart Journal ◽

10.1093/eurheartj/ehx502.p1499 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

K.A. Ageeva ◽

V.N. Abrosimov

Keyword(s):

Heart Failure ◽

Carbon Dioxide ◽

Chronic Obstructive Pulmonary Disease ◽

Chronic Heart Failure ◽

Chronic Obstructive ◽

Walk Test ◽

Obstructive Pulmonary Disease ◽

Six Minute Walk Test ◽

End Tidal ◽

Minute Walk

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Correlation between 6-minute walk distance and spirometry parameters in stable chronic obstructive pulmonary disease patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20185359 ◽

2018 ◽

Vol 7 (1) ◽

pp. 34

Author(s):

Ruchita B. Hajare ◽

Raziya Nagarwala ◽

Ashok Shyam ◽

Parag Sancheti

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Strong Positive Correlation ◽

Walk Test ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Six Minute Walk Test ◽

Tertiary Center ◽

Minute Walk

Background: Six minute walk test (6MWT) is a sub-maximal exercise test, used as a clinical indicator of the functional capacity, in patients with cardiopulmonary diseases. It is simple, objective and reproducible test. The present study was designed to assess correlation of six minute walk test with spirometry parameters, in patients with chronic obstructive pulmonary disease.Methods: In this cross sectional study, fifty patients diagnosed with chronic obstructive pulmonary disease (GOLD criteria) coming to tertiary center were recruited according to inclusion and exclusion criteria. All patients underwent spirometric measurement. Spirometric indices including FEV1, FVC, FEV1/FVC and MVV were tested using computerized spirometer. 6MWT was performed following American Thoracic Society (ATS) guidelines. Percent (%) predicted 6MWD was calculated. Correlation between spirometry and 6MWT was assessed.Results: It was found that correlation between 6MWT and spirometry is statistically significant. There is significant strong positive correlation between percent predicted 6MWD and FEV1 (r=0.850 and p= <0.001), whereas there is significant moderate correlation between percent predicted 6MWD and FVC (r=0.554 and p= <0.001), FEV1/FVC (r=0.509 and p= <0.001) and MVV (r=0.615 and p= <0.001).Conclusions: In chronic obstructive pulmonary disease, percent predicted 6mwd significantly correlated with the spirometry parameters (FEV1, FVC, FEV1/FVC, and MVV). 6MWD decreases as there is decline in the pulmonary function. 6MWT can be a useful replacement of spirometry in assessment of severity of COPD.

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Correlation of spirometry and six minute walk test in patients with chronic obstructive pulmonary disease from Sundargarh, Odisha, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195908 ◽

2019 ◽

Vol 8 (1) ◽

pp. 205

Author(s):

Yara Dinakar ◽

Pradeep Panchadi Kiran ◽

Akshaya K. Mohanty ◽

Praveen Kishore Sahu ◽

Anita Mohanty

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Significant Positive Correlation ◽

Significant Negative Correlation ◽

Chronic Obstructive ◽

Walk Test ◽

Obstructive Pulmonary Disease ◽

Positive Correlation ◽

Six Minute Walk Test ◽

Copd Patients ◽

Minute Walk

Background: Six‑Minute Walk Test (6MWT) is a simple, objective, reproducible test which correlated well with different spirometric indices, and thus able to predict severity of Chronic Obstructive Pulmonary Disease (COPD) and can replace spirometry in resource poor set‑up. Here, author evaluated the correlation of 6 minute walk distance (6MWD) with spirometric indices in COPD patients and the potential of 6MWT as an alternative to the assessment of severity of COPD.Methods: This cross-sectional observational study included a total of 80 COPD patients, diagnosed by GOLD criteria (Post bronchodilator FEV1/ FVC ratio <0.7). Modified Medical Research Council (mMRC) grading was used (age, weight, height, body mass index- BMI and breathlessness) and all the patients underwent spirometric measurement of FEV1, FVC and FEV1/ FVC ratio and tests were repeated after bronchodilation using 200-400 μg of salbutamol. 6MWT was performed following American Thoracic Society (ATS) protocol of 6MWT and distance was measured in meters.Results: Author found significant negative correlation of 6MWT with age (r=-0.384, p=0.00) and mMRC grading of dyspnea (r=-0.559, p=0.00) and significant positive correlation with height (r=0.267, p=0.019) and weight (r=0.293, p=0.008). Significant positive correlation of 6MWD was noted with post bronchodilator FEV1(r=0.608, p=0.00), FEV1% (r=0.429, p=0.00), FVC (r=0.514 p=0.00), FVC% (r=0.313 p=0.005), FEV1/FVC % (r=0.336, p=0.001). Positive correlation was also observed between 6MWT and BMI but statistically insignificant (r=0.177, p=0.116). There was significant negative correlation between 6MWT and GOLD staging (r=-0.536, p=0.00).Conclusions: This finding concludes that 6MWT can be used for the assessment of severity of disease in COPD patients in places where spirometry is not available.

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