scholarly journals Individualized, low-cost and accessible pulmonary rehabilitation program based on functional clinical tests for individuals with COPD—a study protocol of a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marcela Maria Carvalho da Silva ◽  
Juliano Ferreira Arcuri ◽  
Valéria Amorim Pires Di Lorenzo
Keyword(s):  
Pulmonary Rehabilitation ◽  
Low Cost ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Positive Effects ◽  
Link Type ◽  
Rehabilitation Programs ◽  
Clinical Trials Registry

Abstract Background Patients with chronic obstructive pulmonary disease (COPD) present pulmonary and extrapulmonary impairments. The strategies used to mitigate these impairments are pulmonary rehabilitation programs (PRP). However, there is limited access to PRP in specialized centers and the study of low-cost home rehabilitation programs had non-individualized prescription, which might have led to insignificant positive effects. So, it is important to develop new low-cost protocols that involve individualized prescription, as well as physiotherapist supervision. This study describes an accessible, low-cost, and individualized pulmonary rehabilitation protocol and compare its results when performed with or without a weekly physiotherapist-supervised session on patients with COPD. Methods This is a descriptive protocol of a clinical trial, randomized, single-blinded, and type of framework is superiority conducted at the Spirometry and Respiratory Physical Therapy Laboratory of the Federal University of São Carlos (UFSCar). The trial is registered in the Brazilian Clinical Trials Registry (ReBec) URL: http://www.ensaiosclinicos.gov.br/rg/RBR-533hht/ with Register Number UTN code U1111–1220-8245. The sample size is 50 patients and is calculated using the results of a pilot study. Discussion-potential impact and significance of the study It is expected that the low-cost and new supervised rehabilitation program complemented with home exercises will present positive results, especially on exercise capacity, which will make available a more accessible and effective PRP for patients with COPD. Trial registration ClinicalTrials.gov U1111-1220-8245. Registered on September 20, 2018.

scholarly journals Individualized, Low-Cost And Accessible Pulmonary Rehabilitation Program Based On Functional Clinical Tests For Individuals With Copd– A Study Protocol Of A Randomized Controlled Trial

2021 ◽  
Author(s):  
Marcela Maria Carvalho da SILVA ◽  
JULIANO FERREIRA ARCURI ◽  
VALERIA AMORIM PIRES DI LORENZO
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Low Cost ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Positive Effects ◽  
Rehabilitation Programs

Abstract Backgroud:Patients with Chronic Obstructive Pulmonary Disease (COPD) present pulmonary and extrapulmonary impairments. In order to mitigate these impairments, pulmonary rehabilitation programs (PRP) it is an important strategy but the access to PRP in specialized center is limited and the studied of low-cost home rehabilitation programs had non-individualized prescription, which might have led to insignificant positive effects. So, it is important to develop new low-cost protocols that involves individualized prescription, and the influence of physiotherapist supervision. The aim of this study was to describe an accessible, low-cost and individualized pulmonary rehabilitation protocol and compare its results when performing it with or without a weekly physiotherapist-supervised session on patients with COPD. Methods: This is a descriptive protocol of a clinical trial with parallel equivalent groups, conducted at the Spirometry and Respiratory Physical Therapy Laboratory of the Federal University of São Carlos (UFSCar). The trial was registered at Brazilian Clinical Trials Registry (ReBec) URL: http://www.ensaiosclinicos.gov.br/rg/RBR-533hht/ with Register Number RBR-533hht. The sample size was 40 patients and was calculated using the results of a pilot study.Discussion- potencial impact and significance of the study: It is expected that the low cost and new supervised rehabilitation program complemented with home exercises will present positive results especially on exercise capacity, which will make available a more accessible and effective PRP for patients with COPD.Trial registration: The name of the registry was Responsibility of functional tests on supervised rehabilitation program and education program in patients with chronic obstructive pulmonary disease,with registration number: RBR-533hht. The date of registration and start data was September 20, 2018.

Maintaining Effects of Pulmonary Rehabilitation at Home in Chronic Obstructive Pulmonary Disease: A Systematic Literature Review

2021 ◽  
pp. 108482232199037
Author(s):  
Duarte Pinto ◽  
Lissa Spencer ◽  
Soraia Pereira ◽  
Paulo Machado ◽  
Paulino Sousa ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Literature Review ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Maintenance Strategies ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Pulmonary Rehabilitation Program

To systematize strategies that may support patients with Chronic Obstructive Pulmonary Disease to maintain the effects of pulmonary rehabilitation over time. This systematic literature review was conducted, and the evidence was electronically searched in the Web of Science, Scopus, and EBSCO databases. This review included randomized controlled clinical trials, published until September 2019, that addressed components of an unsupervised home-based pulmonary rehabilitation program, maintenance strategies following outpatient pulmonary rehabilitation programs, as well as data on outcomes for quality of life, exercise performance, and dyspnea. A final sample of 5 articles was obtained from a total of 1693 studies. Data for final synthesis were grouped into 2 categories: components of unsupervised home-based pulmonary rehabilitation programs and maintenance strategies. An unsupervised home-based pulmonary rehabilitation program should consist of an educational component, an endurance training component, and a strength training component. When patients are transferred to the home environment, it is important to include more functional exercises specifically adapted to the patient’s condition, goals, and needs.

scholarly journals Effect of counselling during pulmonary rehabilitation on self-determined motivation to be physically active for people with chronic obstructive pulmonary disease: a pragmatic RCT

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne-Kathrin Rausch Osthoff ◽  
Swantje Beyer ◽  
David Gisi ◽  
Spencer Rezek ◽  
Ariane Schwank ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Chronic Obstructive ◽  
Long Term Effects ◽  
Obstructive Pulmonary Disease

Abstract Background Counselling is considered to be a promising approach to increasing physical activity (PA) in people with chronic obstructive pulmonary disease (COPD). The aim of the current study was to investigate whether a PA counselling program for people with COPD, when embedded in a comprehensive outpatient pulmonary rehabilitation (PR) program, increased their daily PA. Methods A two-armed, single blind randomized controlled trial was conducted as a component of a 12-week outpatient pulmonary rehabilitation program. The participants randomized into the intervention group received five counselling sessions, based on the principles of motivational interviewing (MI), with a physiotherapist. The participants’ steps per day and other proxies of PA were measured using an accelerometer (SenseWear Pro®) at baseline, at the end of the PR program, and three months later. The group-by-time interaction effect was analyzed. Results Of the 43 participants,17 were allocated to the intervention group and 26 to the usual-care control group (mean age 67.9 ± 7.9; 21 (49%) males; mean FEV1 predicted 47.1 ± 18.6). No difference between groups was found for any measure of PA at any point in time. Conclusions In this study, counselling, based on MI, when embedded in a comprehensive PR program for people with COPD, showed no short-term or long-term effects on PA behavior. To investigate this potentially effective counselling intervention and to analyze the best method, timing and tailoring of an intervention embedded in a comprehensive outpatient PR program, further adequately powered research is needed. Trial registration: Clinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015).

scholarly journals How resources determine pulmonary rehabilitation programs: A survey among Belgian chest physicians

2018 ◽  
Vol 16 ◽  
pp. 147997231876773 ◽  
Author(s):  
Wim Janssens ◽  
Jean-Louis Corhay ◽  
Peter Bogaerts ◽  
Eric Derom ◽  
Nicolas Frusch ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Online Survey ◽  
Rehabilitation Program ◽  
Direct Access ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Rehabilitation Programs ◽  
Overwhelming Evidence ◽  
Specialized Care

Despite overwhelming evidence of its benefits, a widespread implementation of pulmonary rehabilitation (PR) is lacking and the landscape of multidisciplinary programs remains very scattered. The objective of this study is to assess how PR is organized in specialized care centres in Belgium and to identify which barriers may exist according to respiratory physicians. A telephone and online survey was developed by a Belgian expert panel and distributed among all active Belgian chest physicians ( n = 492). Data were obtained from 200 respondents (40%). Seventy-five percentage of the chest physicians had direct access to an ambulatory rehabilitation program in their hospital. Most of these programs are organized bi or triweekly for an average period of 3–6 months. Programs focus strongly on chronic obstructive pulmonary disease patients from secondary care, have a multidisciplinary approach and provide exercise capacity and quality of life measures as main outcomes. Yet large differences were observed in process and outcome indicators between the programs of centres with standard funding and those of specialized centres with a larger allocated budget. We conclude that multidisciplinary PR programs are available in the majority of Belgian hospitals. Differences in funding determine the quality of the team, the diversity of the interventions and the monitoring of outcomes. More resources for rehabilitation will directly improve the utilization and quality of this essential treatment option in respiratory diseases.

scholarly journals Contribution of Psychological Factors in Dropping out from Chronic Obstructive Pulmonary Disease Rehabilitation Programs

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Athanasios Tselebis ◽  
Epaminondas Kosmas ◽  
Dionisios Bratis ◽  
Argiro Pachi ◽  
Ioannis Ilias ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Educational Status ◽  
Rehabilitation Program ◽  
Drop Out ◽  
Psychological State ◽  
Dropping Out ◽  
Chronic Obstructive ◽  
Paranoid Ideation ◽  
Positive Effects ◽  
Rehabilitation Programs

Significant positive effects, particularly on psychological state in patients who completed the follow-up pulmonary rehabilitation programs, are indicated by a large number of studies. Yet, a remarkable proportion of selected patients drop out from these programs. In this study, we investigated existing differences on psychological variables among COPD patients who complete and those who drop out from pulmonary rehabilitation programs. The study included 144 patients, 43 (29.9%) of whom did not complete the program. SCL-90 was used for the assessment of psychological symptoms. On the SCL-90-R scale 55.6% of patients had abnormal findings. Patients who discontinued the program had higher rates of depression and somatization compared to those who completed it. Regarding the psychopathology scales of SCL-90R, we found that patients who discontinued the program showed higher levels of psychopathology on the scales of somatization, depression, paranoid ideation, and psychotism compared to those who completed the program. The final regression model showed that patients with low educational status and psychotism were more likely to leave the program. In conclusion, psychopathology contributes to patients dropping out from a COPD rehabilitation program; thus, psychological assessment prior to inclusion in rehabilitation programs may reduce dropouts.

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