scholarly journals Effects of Pulmonary Rehabilitation on Lung Functions in Patients with COPD

2014 ◽  
Vol 8 (2) ◽  
pp. 70-76 ◽  
Author(s):  
Mohammad Nesar Uddin Ahmed ◽  
Shelina Begum ◽  
Shamima Sultana ◽  
Taskina Ali

Background: The importance of pulmonary rehabilitation (PR) as a therapeutic measure for COPD patients is well known. Objective: To evaluate the effects of PR program by pursed lip breathing (PLB) and diaphragmatic breathing (DB) on FVC, FEV1, FEV1/FVC ratio in male 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 of the Department of Medicine of BSMMU and NIDCH Dhaka. They were grouped as control (56 patients without PR) and experimental (60 patients with PR). The experimental patients were advised to perform PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. On the contrary, the control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of spirometric lung function status, FVC, FEV1, FEV1/FVC ratio of all subjects were recorded on day 0 and day 60 for both the group by a portable digital MicroDL Spirometer and the statistical analysis was done by independent sample ‘t’ test and paired Student’s ‘t’ test. Results: FVC and FEV1 value were significantly increased in comparison to the control patients after 60 days of follow up. On the other hand, post exercise value of FEV1/FVC ratio was decreased but it was not statistically significant. Conclusion: The study reveals improvement of lung functions with this sort of combination of PR program in stable COPD patients. DOI: http://dx.doi.org/10.3329/jbsp.v8i2.18657 Bangladesh Soc Physiol. 2013, December; 8(2): 70-76

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


Author(s):  
Duarte Pinto ◽  
Soraia Pereira ◽  
Paulo Machado ◽  
Miguel Padilha ◽  
Paulino Sousa

Author(s):  
Grace C. Pereira ◽  
Zoeb K. Rangwala

Pulmonary alveolar proteinosis is a rare lung disease in which surfactant accumulates in the alveoli causing impairment of gas exchange, pulmonary circulation, restrictive lung functions, respiratory and muscular dysfunction. Pulmonary rehabilitation is a core aspect in the management of patients with chronic respiratory diseases. However so far there are no documented studies on the effects of pulmonary rehabilitation in pulmonary alveolar proteinosis. Here authors report the case of a 20 year old female diagnosed with pulmonary alveolar proteinosis and having considerable activity limitations. Pulmonary rehabilitation program of 24 weeks was designed for her after a thorough assessment. The 6-minute walk distance (6 MWD), forced vital capacity (FVC), diffusion capacity for carbon monoxide (DLCO), exercise induced desaturation (SPO2) and QOL were evaluated using the SF-36 questionnaire. All parameters were recorded pre, post and at a follow up at 6 months after pulmonary rehabilitation. The 6MWD, FVC, DLCO, exercise induced desaturation and QOL improved considerably after 24 weeks of PR. At a follow up at 6 months all measures expect the FVC remained maintained. The authors thus conclude that Pulmonary Rehabilitation is effective in improving the exercise capacity, lung functions and quality of life in pulmonary alveolar proteinosis.


2017 ◽  
Vol 14 (4) ◽  
pp. 352-359 ◽  
Author(s):  
Anabel Sciriha ◽  
Stephen Lungaro-Mifsud ◽  
Josianne Scerri ◽  
Rosalie Magro ◽  
Liberato Camilleri ◽  
...  

The St. George’s Respiratory Questionnaire (SGRQ) and chronic obstructive pulmonary disease (COPD) assessment test (CAT) are the measures used to assess health status. This study aims to examine the responsiveness of these tools by severity of dyspnoea category in patients with COPD. Forty-nine COPD patients who underwent a 12-week pulmonary rehabilitation (PR) programme were assessed at baseline, 12 weeks and at 28-week follow-up. Patients were categorized into two groups by severity of dyspnoea category (i.e. mild to moderate (modified Medical Research Council (mMRC) 1–2) and severe to very severe (mMRC 3–4)) using the mMRC dyspnoea scale. Effect size (ES) was computed as estimates of responsiveness. The SGRQ demonstrated greater responsiveness by total sample (SGRQ, ES = 0.87; CAT, ES = 0.75) and for the mMRC 3–4 category (SGRQ, ES = 0.91; CAT, ES = 0.76) on completion of PR. At 28-week follow-up, overall comparable responsiveness of the CAT and SGRQ was identified by total sample (SGRQ, ES = 0.75; CAT, ES = 0.74) and by severity of dyspnoea category. The symptom, impact and activity domains of the SGRQ showed good responsiveness, with greater ESs obtained overall for the mMRC 3–4 category. On completion of PR, the SGRQ demonstrates a greater responsiveness with COPD patients, especially in relation to the mMRC 3–4 category, while both the CAT and SGRQ show comparable responsiveness on follow-up.


Author(s):  
Yu. O. Novikov ◽  
I. E. Salakhov

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.


2020 ◽  
pp. 82-94 ◽  
Author(s):  
V. O. Belash ◽  
L. R. Urazgalieva ◽  
R. I. Fayzullina ◽  
L. G. Agasarov

Introduction. Degenerative-dystrophic changes in the spine are the most common chronic human diseases. Pronounced clinical manifestations of vertebrogenic diseases are observed during active labor activity and represent one of the most frequent causes of temporary disability. It is also known that any pain syndromes are accompanied by the development of psychovegetative disorders, which reduces the effectiveness of treatment. In recent years, there has been a reasonable increase in the interest of the medical community to the non-drug treatment methods. It is caused by the polypharmacotherapy side effects, an increased numbers of allergic reactions, problems with polypragmasia, and a low level of compliance. At the same time, the question of the possibility of various non-drug treatment methods combining is quite acute.The goal of research is to substantiate the clinical effectiveness of the combined application of osteopathic correction and reflexotherapy in the complex treatment of patients with dorsopathy at the cervical-thoracic level.Materials and methods. A prospective controlled randomized study was conducted on the basis of the medical clinics of LLC «Family Health» (Kazan) and ANO «Center for SEB assistance» (Kazan) from April 2018 to May 2019. The study involved 52 people with dorsopathy at the cervical-thoracic level, aged from 25 to 45 years. In accordance with the exclusion criteria, 7 people dropped out of the study. The remaining patients (45 people), depending on the used treatment method, were divided by a simple randomization method using a random number generator into three groups of 15 people. The first group (main group) received osteopathic correction and reflexotherapyon the background of standard drug therapy; the second and the third groups (control groups) received only osteopathic correction orreflexotherapy, respectively, on the background of standard drug therapy. The osteopathic examination was performed for all patients regardless of the group, before and after the course of therapy, with the formation of an osteopathic conclusion.Also there was the estimation of the degree of pain syndrome severity,the asthenia, and the degree of accumulated emotional and energy charge that does not get out in a person.Results. It was found in the course of the study that the inclusion of osteopathic correction and reflexotherapy in the complex therapy of patients with dorsopathy at the cervical-thoracic level is clinically more effective than the isolated use of these methods. Such complex therapy allows to achieve a more significant reduction in the severity of the pain syndrome by VAS (p<0,05), relief of internal emotional tension (p<0,05), and increase the effectiveness of correction of dominant somatic dysfunction. Based on the obtained data, it could be assumed that reflexotherapy potentiates the effects of osteopathic correction.Conclusion. Based on the study, it can be concluded that the combination of osteopathic correction and reflexotherapy in the treatment of patients with dorsopathy at the cervical-thoracic level increases the clinical effectiveness of the standard drug therapy. At the same time, it is worth noting the potentiating effect of the combined use of two non-medicinal methods. The question of combining of various non-drug treatment methods is quite acute today, so this study will be continued. 


2020 ◽  
Vol 16 (1) ◽  
pp. 11-15
Author(s):  
Md Waliul Islam ◽  
Md Abul Hossain ◽  
Md Nurul Hooda ◽  
Kazi Rafiqul Abedin ◽  
Husne Ara

Objectives: To evaluate urinary symptoms and quality of life in patient with BPH before and after TURP. To determine the impact of TURP on the urinary symptoms (IPSS) and peak urinary flow rate. Methods: This study is prospective study carried out between 2010 and 2011 in the department of Urology, National Institute of Kidney Diseases & Urology. Total 102 cases were selected purposively according to selection criteria. Each patient was observed and followed up at 8 weeks (1st visit), 16 weeks (2nd visit) 24 weeks (3rd visit) after transurethral resection of prostate (TURP). IPSS score, QOL score also recorded and uroflowmetry was done to see the peak urinary flow rate (Qmax) of urine and voiding time. USG was done to see post voidal residual urine volume and DRE also done in selected cases. Data was complied and statistical analysis were done using computer based software, Statistical Package for Social Science (SPSS), using paired ‘t’ test. A P value <0.05 was taken as significance. Results: Before TURP, IPSS range 17-25 and mean 21.61+2.43, after TURP, range 0-7 and mean 4.27+1.71). Hence a significant improvement of IPSS was found from 2 months to 6 months follow up after TURP. The change was tested using “paired student ‘t’ test”. Before TURP Qmax range 7-12.2 and mean was 9.96+1.69, which became range 18-25 and mean was 22.61+2.28 after TURP and therefore change of mean Qmax was 12.64+2.69. The change was tested using “paired student ‘t’ test”. The change was found significant (P<0.001). Conclusion: Transurethral resection of prostate resolves obstructive symptoms, rapid improvement of urinary flow rate Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.11-15


2020 ◽  
Vol 19 (2) ◽  
pp. 64-68
Author(s):  
Mrinmoy Biswas ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman ◽  
Sharif Mohammad Wasimuddin

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68


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