scholarly journals A COMPREHENSIVE PULMONARY REHABILITATION PROGRAM FOR THE MANAGEMENT OF POSTTUBERCULOSIS PNEUMOTHORAX: A CASE STUDY

Author(s):  
Vaishnavi Yadav

Pulmonary tuberculosis is a contagious disease of the lung caused by mycobacterium tuberculosis. The disease is curable and preventable, but its sequelae induce structural lung damage, physiological dysfunction resulting in disability, respiratory distress, and decreased exercise capacity affecting ADLs. Pneumothorax is considered to be a major complication of TB among all the known sequelae. In the present case, the patient complained of moderate dyspnea, chest pressure, and chest pain. Based on chest radiography and a previous diagnosis of pulmonary tuberculosis, the patient was diagnosed with secondary spontaneous pneumothorax (SSP). The pneumothorax was relieved by medical intervention, i.e. by intercostal drainage, but our goal was to increase the ventilation and oxygenation of the lungs, improve airways hygiene, improve the exercise tolerance and minimize the work of breathing so that the patient can go back to his normal day-to-day activities without any trouble. A comprehensive pulmonary rehabilitation plan was structured to suit the patient's goal and was implemented and routinely followed for 1 month. It included a range of interventions like breathing exercises, airway clearance techniques, physical mobility exercises, and posture retraining. The patient demonstrated significant functional improvement in aerobic capacity, endurance, exercise tolerance capacity, and increased shoulder joint mobility. In the present case, it has also been validated that medical management anchored with Pulmonary Rehabilitation will help in gaining better outcomes.

2017 ◽  
Vol 37 (3) ◽  
pp. 214-222 ◽  
Author(s):  
Yasemin Türk ◽  
Astrid van Huisstede ◽  
Frits M. E. Franssen ◽  
Pieter S. Hiemstra ◽  
Arjan Rudolphus ◽  
...  

2015 ◽  
Vol 9 (2) ◽  
pp. 65-71
Author(s):  
Mohammad Nesar Uddin Ahmed ◽  
Shelina Begum ◽  
Taskina Ali

Background: Pulmonary rehabilitation (PR) is known to be therapeutically useful for COPD patients. Objective: To evaluate the effects of combination of breathing exercises (pursed lip breathing and diaphragmatic breathing) and lower extremity endurance training (LEET) as part of PR program on six minute walk distance (6MWD), on oxygen saturation (SpO2%), on the level of dyspnea and fatigue in patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department (OPD) of the Department of Medicine of BSMMU and NIDCH Dhaka. 56 patients without PR constituted control group and experimental group included 60 patients intervened with PR. The experimental patients were advised to perform the PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. The control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of exercise tolerance, 6MWD, SpO2%, the level of dyspnea and fatigue of all subjects were recorded on day 0 and day 60 for both the groups. SpO2% was recorded by portable Pulse Oximeter and the level of dyspnea as well as fatigue were recorded by Modified Borg Scale. Statistical analysis was done by independent sample ‘t’ test and paired sample ‘t’ test. Results: Significant improvement were observed in 6MWD, SpO2%, the level of dyspnea and fatigue in patients who performed PR program. In addition, significant improvement in these parameters were observed after completing PR program compared to the beginning of the intervention. Conclusion: The study concludes that regular exercise of all components of PR program significantly improve exercise tolerance in COPD patients DOI: http://dx.doi.org/10.3329/jbsp.v9i2.22799 Bangladesh Soc Physiol. 2014, December; 9(2): 65-71


2019 ◽  
Vol 8 (7) ◽  
pp. 1052
Author(s):  
Paneroni ◽  
Vogiatzis ◽  
Belli ◽  
Savio ◽  
Visca ◽  
...  

Patients with severe chronic obstructive pulmonary disease (COPD) are unable to exercise at high intensities for sufficiently long periods of time to obtain true physiological training effects. It therefore appears sensible to increase training duration at sub-maximal exercise intensities to optimize the benefit of exercise training. We compared the effects on exercise tolerance of two endurance cycloergometer submaximal exercise protocols with different cumulative training loads (one (G1) versus two (G2) daily 40 min training sessions) both implemented over 20 consecutive days in 149 patients with COPD (forced expiratory volume at first second (FEV1): 39% predicted) admitted to an inpatient pulmonary rehabilitation program. Patients in G2 exhibited greater improvement (p = 0.011) in submaximal endurance time (from 258 (197) to 741 (662) sec) compared to G1 (from 303 (237) to 530 (555) sec). Clinically meaningful improvements in health-related quality of life, 6MWT, and chronic dyspnea were not different between groups. Doubling the volume of endurance training is feasible and can lead to an additional benefit on exercise tolerance. Future studies may investigate the applicability and benefits of this training strategy in the outpatient or community-based pulmonary rehabilitation settings to amplify the benefits of exercise interventions.


Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.


2021 ◽  
pp. 108482232199037
Author(s):  
Duarte Pinto ◽  
Lissa Spencer ◽  
Soraia Pereira ◽  
Paulo Machado ◽  
Paulino Sousa ◽  
...  

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.


Sign in / Sign up

Export Citation Format

Share Document