scholarly journals The Role of Manual Therapy in Patients with COPD

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 21 ◽  
Author(s):  
Stephanie Clarke ◽  
Prue E. Munro ◽  
Annemarie L. Lee

Chronic obstructive pulmonary disease (COPD) is a respiratory condition associated with altered chest wall mechanics and musculoskeletal changes. In this narrative review, we describe the underlying musculoskeletal abnormalities in COPD, the reasons for applying manual therapy techniques, their method of application and clinical effects. A variety of manual therapy techniques have been applied in individuals with COPD, including soft tissue therapy, spinal and joint manipulation and mobilisation, and diaphragmatic release techniques. These have been prescribed in isolation and in conjunction with other treatments, including exercise therapy. When applied in isolation, transient benefits in respiratory rate, heart rate and symptoms have been reported. Combined with exercise therapy, including within pulmonary rehabilitation, benefits and their corresponding clinical relevance have been mixed, the extent to which may be dependent on the type of technique applied. The current practical considerations of applying these techniques, including intense therapist–patient contact and the unclear effects in the long term, may limit the broad use of manual therapy in the COPD population. Further high quality research, with adequate sample sizes, that identifies the characteristic features of those with COPD who will most benefit, the optimal choice of treatment approach and the longevity of effects of manual therapy is required.

Author(s):  
Francesco Infarinato ◽  
Stephanie Jansen-Kosterink ◽  
Paola Romano ◽  
Lex van Velsen ◽  
Harm op den Akker ◽  
...  

Pervasive health technologies can increase the effectiveness of personal health monitoring and training, but more user studies are necessary to understand the interest for these technologies, and how they should be designed and implemented. In the present study, we evaluated eWALL, a user-centered pervasive health technology consisting of a platform that monitors users’ physical and cognitive behavior, providing feedback and motivation via an easy-to-use, touch-based user interface. The eWALL was placed for one month in the home of 48 subjects with a chronic condition (chronic obstructive pulmonary disease—COPD or mild cognitive impairment—MCI) or with an age-related impairment. User acceptance, platform use, and potential clinical effects were evaluated using surveys, data logs, and clinical scales. Although some features of the platform need to be improved before reaching technical maturity and making a difference in patients’ lives, the real-life evaluation of eWALL has shown how some features may influence patients’ intention to use this promising technology. Furthermore, this study made it clear how the free use of different health apps is modulated by the real needs of the patient and by their usefulness in the context of the patient’s clinical status.


2019 ◽  
Vol 02 (04) ◽  
pp. 185-191
Author(s):  
Yuhua Wu ◽  
Jian Zhou ◽  
Mengyu Ma ◽  
Jing Xie ◽  
Ahong Wang ◽  
...  

Objective: To investigate the clinical effects of the use of portable pulmonary function tester in patients with stable Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 80 patients with stable COPD were enrolled in our hospital from March 2018 to March 2019. They were divided into two groups according to different treatment methods. The comparison group was used for routine pulmonary function training, and the intervention group was trained for Portable Pulmonary Function Training and Test Device (PPFTTD). Comparison was made of forced expiratory volume in one second/forced vital capacity (FEV1/FVC), measured/predicted value of the first second forced expiratory volume (FEV1 measured/predicted value), measured/predicted value of maximal voluntary ventilation per minute between the two groups. Quality of life (QOL) scores such as daily living ability, social activity, depressive psychological symptoms, and anxiety psychological symptoms were measured. Results: The FEV1/FVC value, measured/predicted value of FEV1 and MVV of intervention group were higher than those in the comparison group ([Formula: see text]). QOL scores, such as daily living ability, social activity, depression psychological symptoms, and anxiety psychological symptoms in the intervention group, were lower than those in the comparison group ([Formula: see text]). Conclusion: In the treatment of stable COPD, the use of portable pulmonary function tester is significant, and it should be widely promoted and applied in clinical practice.


2019 ◽  
Vol 5 (1) ◽  
pp. 00225-2018 ◽  
Author(s):  
Florence Schleich ◽  
Andras Bikov ◽  
Alexander G. Mathioudakis ◽  
Melissa McDonnell ◽  
Cecilia Andersson ◽  
...  

The annual European Respiratory Society (ERS) International Congress (held in Paris in 2018) was once again a platform for discussion of the highest-quality scientific research, cutting-edge techniques and innovative new therapies within the respiratory field. This article discusses only some of the high-quality research studies presented at this year's Congress, with a particular focus on airway diseases including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cough, as presented through Assembly 5 of the ERS (Airway Diseases: Asthma and COPD). The authors establish the key take-home messages of these studies, compare their findings and place them in the context of current understanding.


Author(s):  
Gül Deniz Yilmaz Yelvar ◽  
Yasemin Çirak ◽  
Yasemin Parlak Demir ◽  
Murat Dalkilinç ◽  
Deniz Kizilirmak ◽  
...  

2019 ◽  
Vol 126 (1) ◽  
pp. 67-76 ◽  
Author(s):  
James P. Hummel ◽  
Martin L. Mayse ◽  
Steve Dimmer ◽  
Philip J. Johnson

Parasympathetic efferent innervation of the lung is the primary source of lung acetylcholine. Inhaled long-acting anticholinergics improve lung function and symptoms in patients with chronic obstructive pulmonary disease. Targeted lung denervation (TLD), a bronchoscopic procedure intended to disrupt pulmonary parasympathetic inputs, is an experimental treatment for chronic obstructive pulmonary disease. The physiologic and histologic effects of TLD have not previously been assessed. Eleven sheep and two dogs underwent circumferential ablation of the main bronchi with simultaneous balloon surface cooling using a lung denervation system (Nuvaira, Inc., Minneapolis, MN). Changes in pulmonary air flow resistance were monitored before and following TLD. Four animals were assessed for the presence or abolishment of the sensory axon-mediated Hering-Breuer reflex before and following TLD. Six sheep were histologically evaluated 30 days post-TLD for the extent of lung denervation (axonal staining) and effect on peribronchial structures near the treatment site. No adverse clinical effects were seen in any treated animals. TLD produced a ~30% reduction in pulmonary resistance and abolished the sensory-mediated Hering-Breuer reflex. Axonal staining was consistently decreased 60% at 30 days after TLD. All treated airways exhibited 100% epithelial integrity. Damage to other peribronchial structures was minimal. Tissue 1 cm proximal and distal to the treatment was normal, and the esophagus and periesophageal vagus nerve branches were unaffected. TLD treatment effectively denervates the lung while protecting the bronchial epithelium and minimizing effects on peribronchial structures. NEW & NOTEWORTHY The feasibility of targeted lung denervation, a new minimally invasive therapy for obstructive lung disease, has been demonstrated in humans with preliminary clinical studies demonstrating improvement in symptoms, pulmonary function, and exercise capacity in patients with chronic obstructive pulmonary disease. This preclinical animal study demonstrates the ability of targeted lung denervation to disrupt vagal inputs to the lung and details its physiologic and histopathologic effects.


Author(s):  
Anneroos Sinnige ◽  
Maik Sliepen ◽  
Marc R. Scheltinga ◽  
Joep A.W. Teijink

Non-communicable diseases (NCDs) are a major cause of disability and mortality worldwide. Physical inactivity is an important contributor to the development of NCDs. Increasing physical activity through supervised exercise therapy (SET) is proven to be effective, and is a key component in both the prevention and treatment of most NCDs. However, only a minority of patients with NCDs receive this treatment, mainly due to an insufficient number and poor accessibility of specialized physical therapists. The aim of this article is to describe a solution that, if indicated, enables all patients with NCDs in the Netherlands to receive SET by a specialized physical therapist: Chronic CareNet. Chronic CareNet is a nationwide network of specialized physical therapists, providing high quality SET and lifestyle counselling to patients with NCDs, initially focusing on peripheral arterial disease, chronic obstructive pulmonary disease and coronary heart disease. The network evolved from ClaudicatioNet. In order to monitor quality of care, therapists enroll in a continuous educational program, and process and outcome indicators are collected by all therapists, which can be compared with a nationwide benchmark (quality system). A robust infrastructure of information and communication technology provides an online care finder and referral system to locate and refer to nearby therapists. All elements of Chronic CareNet are essential, to ensure that all patients in the Netherlands have access to a nearby specialized therapist.


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