scholarly journals Long-Term Maintenance Strategies after Pulmonary Rehabilitation: Perspectives of People with Chronic Respiratory Diseases, Informal Carers, and Healthcare Professionals

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 119
Author(s):  
Sara Souto-Miranda ◽  
Cláudia Dias ◽  
Cristina Jácome ◽  
Elsa Melo ◽  
Alda Marques
Keyword(s):  
Peer Support ◽  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Healthcare Professionals ◽  
Chronic Respiratory Diseases ◽  
Institutional Practice ◽  
City Councils ◽  
Active Lifestyles ◽  
Informal Carers

Pulmonary rehabilitation (PR) is an effective intervention for people with chronic respiratory diseases (CRD); however, its effects fade after 6–12 months. Community-based strategies might be valuable to sustain PR benefits, but this has been little explored. People with CRD, informal carers, and healthcare professionals (HCPs) were recruited from pulmonology appointments of two local hospitals, two primary care centres, and one community institutional practice and through snowballing technique. Focus groups were conducted using a semi-structured guide. Data were thematically analysed. Twenty-nine people with CRD (24% female, median 69 years), 5 informal carers (100% female, median 69 years), and 16 HCPs (75% female, median 36 years) were included. Three themes were identified: “Maintaining an independent and active lifestyle” which revealed common strategies adopted by people with “intrinsic motivation and professional and peer support” as key elements to maintain benefits, and that “access to information and partnerships with city councils’ physical activities” were necessary future steps to sustain active lifestyles. This study suggests that motivation, and professional and peer support are key elements to maintaining the benefits of PR in people with CRD, and that different physical activity options (independent or group activities) considering peoples’ preferences, should be available through partnerships with the community, namely city councils.

scholarly journals Barriers and enablers to pulmonary rehabilitation in low- and middle-income countries: a qualitative study of healthcare professionals

2021 ◽  
Author(s):  
Fanuel Bickton ◽  
Harriet Shannon
Keyword(s):  
Qualitative Study ◽  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Healthcare Professionals ◽  
Successful Implementation ◽  
Middle Income ◽  
Chronic Respiratory Diseases ◽  
Middle Income Countries ◽  
Barriers And Enablers ◽  
Low And Middle Income

Abstract Low- and middle-income countries bear a disproportionately high burden of global morbidity and mortality caused by chronic respiratory diseases. Pulmonary rehabilitation is recommended as a core intervention in the management of people with chronic respiratory diseases. However, the intervention remains poorly accessed/utilised globally, especially in low- and middle-income countries. This qualitative study explored barriers and enablers to pulmonary rehabilitation in low- and middle-income countries from the perspective of healthcare professionals with pulmonary rehabilitation experience in these settings. Online-based semi-structured in-depth interviews with healthcare professionals were undertaken to data saturation, exploring lived barriers and enablers to pulmonary rehabilitation in their low- or middle-income country. Anonymised Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. A total of seven healthcare professionals from seven low- and middle-income countries representing Africa, Asia, and South America, were interviewed. They included five physiotherapists (four females), one family physician (male), and one pulmonologist (female). Themes for barriers to pulmonary rehabilitation included limited resources, low awareness, Coronavirus Disease 2019, and patient access-related costs. Themes for enablers included local adaptation, motivated patients, Coronavirus Disease 2019 (which spanned both enablers and barriers), better awareness/recognition, provision of PR training, and resource support. Successful implementation of these enablers will require engagement with multiple stakeholders. The findings of this study are a necessary step towards developing strategies that can overcome the existing pulmonary rehabilitation evidence-practice gap in low- and middle-income countries and alleviating the burden of chronic respiratory diseases in these countries.

Pulmonary Rehabilitation in Children with Chronic Respiratory Diseases

2020 ◽  
pp. 661-668
Author(s):  
Rodrigo Torres Castro ◽  
Homero Puppo Gallardo ◽  
Daniel Zenteno Araos
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Chronic Respiratory Diseases

scholarly journals Association between Lifetime Tobacco Use and Alcohol Consumption Trajectories and Cardiovascular and Chronic Respiratory Diseases among Older People

2021 ◽  
Vol 18 (21) ◽  
pp. 11275
Author(s):  
Ignacio Madero-Cabib ◽  
Claudia Bambs
Keyword(s):  
Alcohol Consumption ◽  
Older People ◽  
Life Course ◽  
Tobacco Use ◽  
Respiratory Diseases ◽  
Chronic Respiratory Diseases ◽  
Logistic Regression Models ◽  
Improved Design ◽  
The Life Course

Background: We identify representative types of simultaneous tobacco use and alcohol consumption trajectories across the life course and estimate their association with cardiovascular and chronic respiratory diseases (CVDs and CRDs) among older people in Chile. Methods: We used data from a population-representative, face-to-face and longitudinal-retrospective survey focused on people aged 65–75 (N = 802). To reconstruct trajectory types, we employed weighted multichannel sequence analysis. Then, we estimated their associations with CVDs and CRDs through weighted logistic regression models. Results: Long-term exposure to tobacco use and alcohol consumption across life are associated with the highest CVD and CRD risks. Long-term nonsmokers and nondrinkers do not necessarily show the lowest CVDs and CRDs risks if these patterns are accompanied by health risk factors such as obesity or social disadvantages such as lower educational levels. Additionally, trajectories showing regular consumption in one domain but only in specific periods of life, whether early or late, while maintaining little or no consumption across life in the other domain, lead to lower CVDs or CRDs risks than trajectories indicating permanent consumption in both domains. Conclusions: A policy approach that considers CVDs and CRDs as conditions that strongly depend on previous individual experiences in diverse life domains can contribute to the improved design and evaluation of preventive strategies of tobacco use and alcohol consumption across the life course.

scholarly journals Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review

2020 ◽  
Vol 24 (10) ◽  
pp. 991-999
Author(s):  
F. M. Bickton ◽  
C. Fombe ◽  
E. Chisati ◽  
J. Rylance
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Sub Saharan Africa ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Exercise Regimen ◽  
Home Based ◽  
Sub Saharan ◽  
Randomised Controlled

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.

Assessment of pulmonary rehabilitation (PR) safety in patients with chronic respiratory diseases

2017 ◽  
Author(s):  
Francesco Gigliotti ◽  
Elisabetta Maria Romano ◽  
Emanuele Vulpio ◽  
Alessio Lazzeri ◽  
Carla Castellani ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Chronic Respiratory Diseases

scholarly journals PHYSIOTHERAPY REHABILITATION IN LONG COVID: A CASE SERIES

2020 ◽  
pp. 81-82
Author(s):  
Khushali Jain ◽  
Mariya Jiandani ◽  
Pramila Lohakare
Keyword(s):  
Pulmonary Rehabilitation ◽  
Tertiary Care ◽  
Case Series ◽  
Functional Impairments ◽  
Tertiary Care Centre ◽  
Multisystem Disease ◽  
Chronic Respiratory Diseases ◽  
Face To Face

SARS-CoV-2 2 also known COVID 19, has been observed to cause long term functional impairments. There have been reports of post covid discharge symptoms such as dyspnoea, fatigue, and reduced overall capacity. Physiotherapy is an integral component of pulmonary rehabilitation. It plays a key role in improving functional status and quality of life in patients with chronic respiratory diseases. COVID 19 being a multisystem disease with primary affection of the lung can be benefitted with physiotherapy intervention. We present a case series of four patients with complaints of dyspnoea and fatigue post covid, enrolled for face to face pulmonary rehabilitation at our tertiary care centre.

scholarly journals Active Video Games for Rehabilitation in Respiratory Conditions: Systematic Review and Meta-Analysis (Preprint)

2018 ◽  
Author(s):  
Joshua Simmich ◽  
Anthony J Deacon ◽  
Trevor G Russell
Keyword(s):  
Outcome Measures ◽  
Respiratory Diseases ◽  
Meta Analysis ◽  
Mean Difference ◽  
Single Session ◽  
Chronic Respiratory Diseases ◽  
Active Video Games ◽  
Active Video ◽  
Respiratory Conditions

BACKGROUND Exercise and physical activity are key components of treatment for chronic respiratory diseases. However, the level of physical activity and adherence to exercise programs are low in people with these diseases. Active video games (AVGs) may provide a more engaging alternative to traditional forms of exercise. OBJECTIVE This review examines the effectiveness of game-based interventions on physiological outcome measures, as well as adherence and enjoyment in subjects with chronic respiratory diseases. METHODS A systematic search of the literature was conducted, with full texts and abstracts included where they involved an AVG intervention for participants diagnosed with respiratory conditions. A narrative synthesis of included studies was performed. Additionally, meta-analysis comparing AVGs with traditional exercise was undertaken for 4 outcome measures: mean heart rate (HR) during exercise, peripheral blood oxygen saturation (SpO2) during exercise, dyspnea induced by the exercise, and enjoyment of the exercise. RESULTS A total of 13 full-text papers corresponding to 12 studies were included in the review. Interventions predominantly used games released for the Nintendo Wii (8 studies) and Microsoft Xbox Kinect (3 studies). There were 5 studies that examined the acute effects of a single session of AVGs and 7 studies that examined the long-term effects after multiple sessions of AVGs. Trials conducted over more than 1 session varied in duration between 3 and 12 weeks. In these, AVG interventions were associated with either similar or slightly greater improvements in outcomes such as exercise capacity when compared with a traditional exercise control, and they also generally demonstrated improvements over baseline or nonintervention comparators. There were a few studies of unsupervised AVG interventions, but the reported adherence was high and maintained throughout the intervention period. Additionally, AVGs were generally reported to be well liked and considered feasible by participants. For outcome measures measured during a single exercise session, there was no significant difference between an AVG and traditional exercise for HR (mean difference 1.44 beats per minute, 95% CI –14.31 to 17.18), SpO2 (mean difference 1.12 percentage points, 95% CI –1.91 to 4.16), and dyspnea (mean difference 0.43 Borg units, 95% CI –0.79 to 1.66), but AVGs were significantly more enjoyable than traditional exercise (Hedges g standardized mean difference 1.36, 95% CI 0.04-2.68). CONCLUSIONS This review provides evidence that AVG interventions, undertaken for several weeks, can provide similar or greater improvements in exercise capacity and other outcomes as traditional exercise. Within a single session of cardiovascular exercise, an AVG can evoke similar physiological responses as traditional exercise modalities but is more enjoyable to subjects with chronic respiratory diseases. However, there is very limited evidence for adherence and effectiveness in long-term unsupervised trials, which should be the focus of future research.

scholarly journals Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050362
Author(s):  
Md Nazim Uzzaman ◽  
Soo Chin Chan ◽  
Ranita Hisham Shunmugam ◽  
Julia Patrick Engkasan ◽  
Dhiraj Agarwal ◽  
...  
Keyword(s):  
Usual Care ◽  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Clinical Effectiveness ◽  
Published Data ◽  
Chronic Respiratory Diseases ◽  
Functional Exercise ◽  
Functional Exercise Capacity

IntroductionChronic respiratory diseases (CRDs) are common and disabling conditions that can result in social isolation and economic hardship for patients and their families. Pulmonary rehabilitation (PR) improves functional exercise capacity and health-related quality of life (HRQoL) but practical barriers to attending centre-based sessions or the need for infection control limits accessibility. Home-PR offers a potential solution that may improve access. We aim to systematically review the clinical effectiveness, completion rates and components of Home-PR for people with CRDs compared with Centre-PR or Usual care.Methods and analysisWe will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for ‘Chronic Respiratory Disease’ AND ‘Pulmonary Rehabilitation’ AND ‘Home-PR’, and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR?Ethics and disseminationResearch ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences.PROSPERO registration numberCRD42020220137.

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