scholarly journals Eight Weeks of Pulmonary Rehabilitation in Patients with Pulmonary Embolism: A Preliminary Report

Proceedings ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 37
Author(s):  
Stavrou ◽  
Griziotis ◽  
Raptis ◽  
Bardaka ◽  
Karetsi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Pulmonary Rehabilitation ◽  
Intermittent Exercise ◽  
Cardiopulmonary Exercise Testing ◽  
Supervised Exercise ◽  
Sf 36 ◽  
Respiratory Physiotherapy ◽  
Safe Intervention

Aim: Pulmonary rehabilitation (PR) is an important and safe intervention which can improve health indicators and quality of life. The purpose of our study was to investigate the effect of 8 weeks of PR in patients with pulmonary embolism (PE) during (tele)rehabilitation and self-selected exercise (SSE) versus supervised exercise in a rehabilitation center (SE). Material & Method: 14 patients with PE participated in our study (age, 50.7 ± 15.1 yrs; BMI, 30.0 ± 3.3 kg/m2; male, 78.6%) and were divided into two groups (SSE, n = 7, vs. SE, n = 7). Inclusion criteria were diagnosis of PE > 6 months and weekly exercise ≤ 100 min. For each patient, demographics, characteristics of PE episodes, follow-up after the thromboembolic event, and echocardiography were recorded. Before and after the PR program we recorded anthropometric characteristics and questioners [Quality of life (SF-36) and Pittsburg sleep quality index (PSQI)], and we performed blood sampling for NT-proBNB measurement. Patients underwent cardiopulmonary exercise testing until exhausting.The PR exercise program included the following: SE, 3/w, 30-min intermittent exercise 1/1 in cycle ergometer at 70% VO2max calculated from heart rate, 10-min respiratory physiotherapy, and 10-min strength exercises; SSE, 50-min walking at 60% VO2max, 10-min (tele)respiratory physiotherapy and 10-min strength exercise. Results: The SSE group differed in mean arterial pressure at the end of ergospirometry pre- and post-PR (87.6 ± 3.3 vs. 95.0 ± 5.5 mmHg, p< 0.05). All patients showed differences pre-and post-PR in SF-36 (general health, 57.5 ± 14.9 vs. 63.8 ± 20.5 p< 0.05; physical health, 63.8 ± 189 vs. 75.6 ± 14.5, p< 0.05) and PSQI (cannot get to sleep within 30 min, 5.3 ± 2.2 vs. 3.5 ± 1.7, p< 0.05; enthusiasm, 1.3 ± 0.7 vs. 0.3 ± 0.5 p< 0.05) but we observed no differences between groups. The ΝΤ-proBNB (73.8 ± 11.8 vs. 104.0 ± 55.7 pg/mL) and ergospirometry parameters were not significantly different pre- and post-PR or between groups. Conclusions: PR may present a safe intervention in patients with PE. Post-PR results are similar in patients with SE and SSE.

scholarly journals Supervised Versus Unsupervised Pulmonary Rehabilitation in Patients with Pulmonary Embolism: A Valuable Alternative in COVID Era

2021 ◽  
Vol 6 (4) ◽  
pp. 98
Author(s):  
Vasileios T. Stavrou ◽  
Michalis Griziotis ◽  
George D. Vavougios ◽  
Dimitrios G. Raptis ◽  
Fotini Bardaka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Sleep Quality ◽  
Pulmonary Rehabilitation ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiac Biomarkers ◽  
Pittsburg Sleep Quality Index ◽  
Sf 36 ◽  
Before And After

The aim of our study was to assess the effect of 8 weeks of pulmonary rehabilitation (PR) in patients with pulmonary embolism (PE) during unsupervised PR (unSPRgroup) versus supervised PR (SPRgroup) on cardiopulmonary exercise testing (CPET) parameters, sleep quality, quality of life and cardiac biomarkers (NT-pro-BNP). Fourteen patients with PE (unSPRgroup, n = 7, vs. SPRgroup, n = 7) were included in our study (age, 50.7 ± 15.1 years; BMI, 30.0 ± 3.3 kg/m2). We recorded anthropometric characteristics and questionnaires (Quality of life (SF-36) and Pittsburg sleep quality index (PSQI)), we performed blood sampling for NT-pro-BNP measurement and underwent CPET until exhausting before and after the PR program. All patients were subjected to transthoracic echocardiography prior to PR. The SPRgroup differed in mean arterial pressure at rest before and after the PR program (87.6 ± 3.3 vs. 95.0 ± 5.5, respectively, p = 0.010). Patients showed increased levels of leg fatigue (rated after CPET) before and after PR (p = 0.043 for SPRgroup, p = 0.047 for unSPRgroup) while the two groups differed between each other (p = 0.006 for post PR score). Both groups showed increased levels in SF-36 scores (general health; p = 0.032 for SPRgroup, p = 0.010 for unSPRgroup; physical health; p = 0.009 for SPRgroup, p = 0.022 for unSPRgroup) and reduced levels in PSQI (cannot get to sleep within 30-min; p = 0.046 for SPRgroup, p = 0.007 for unSPRgroup; keep up enough enthusiasm to get things done; p = 0.005 for SPRgroup, p = 0.010 for unSPRgroup) following the PR program. The ΝT-pro-BNP was not significantly different before and after PR or between groups. PR may present a safe intervention in patients with PE. The PR results are similar in SPRgroup and unSPRgroup.

Dyspnea, Quality of Life and Walking Capacity during 1 Year Follow-up after a First Episode of Pulmonary Embolism: Results of the E.L.O.P.E. Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 750-750
Author(s):  
Susan R Kahn ◽  
Andrew Hirsch ◽  
Margaret Beddaoui ◽  
Arash Akaberi ◽  
David Anderson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Cardiopulmonary Exercise Testing ◽  
Physical Component Score ◽  
Component Score ◽  
Sf 36 ◽  
Walking Capacity ◽  
Acute Pe

Abstract Background: Most pulmonary embolism (PE) research has focused on outcomes such as mortality and PE recurrence. Patient-centered outcomes such as persistent dyspnea, impaired quality of life (QOL) and reduced walking capacity after PE have been largely unstudied. To address this knowledge gap, we performed the ELOPE (Evaluation of Longterm Outcomes after PE) study, a prospective, observational, multicenter cohort study of long-term outcomes after acute PE (www.clinicaltrials.gov NCT01174628). Objectives: To describe and quantify dyspnea, quality of life and walking capacity during the 1 year following PE diagnosis. Methods: Patients ³ 18 years old with a 1st episode of acute PE diagnosed within the previous 10 days screened at 5 Canadian recruiting centers were potentially eligible to participate. Exclusion criteria were subsegmental-only PE, preexisting severe cardiopulmonary comorbidity, previous proximal DVT, contraindication to CT pulmonary angiography, life expectancy &lt;1 year, unable to read questionnaire in English and French or to attend follow-up visits, and unable or unwilling to consent. At baseline, 1, 3, 6 and 12 months after PE, we measured dyspnea (UCSD Shortness of Breath Questionnaire [SOBQ]), generic QOL (SF-36), PE-specific QOL (PEmbQoL), and walking capacity (6-minute walk test (6MWT)). Cardiopulmonary exercise testing (CPET) was performed at 1 year; the primary outcome of the study was maximal aerobic capacity defined by peak oxygen uptake (VO2) as a percent of predicted maximal VO2 (VO2max) on 1-year CPET, with &lt;80% predicted VO2max considered abnormal, as per American Thoracic Society guidelines. For this analysis, we summarized demographic and clinical characteristics of study subjects, and calculated mean (SD) dyspnea scores, QOL scores and 6MWT distance at each study visit during 1 year follow-up in the total population and according to 1-year CPET result. Results: 984 patients were screened for participation; of these, 150 were eligible and 100 (67%) consented to participate. Mean (SD) age was 50 (15) years, 57% were male, 80% were outpatients and 33% had concomitant DVT. PE was provoked in 21% and unprovoked in 79%; none were cancer-related. During 1 year follow-up, SOBQ scores improved by an average of 16.9 points compared with baseline, SF-36 PCS (physical component score) by 9.0 points, SF-36 MCS (mental component score) by 5.6 points, PEmbQoL (e.g. intensity of complaints dimension) by 33.4 points, and 6MWT by 43 meters. Improvement tended to be more marked during the first 3 months after PE and tapered off thereafter. For all measures, degree of improvement was significantly reduced and 1 year scores were significantly worse among the 46.5% (40/86) of patients with &lt;80% predicted VO2max on 1-year CPET (e.g., SF-36 PCS: see Figure). Conclusions: On average, dyspnea, QOL and walking capacity improve during the year after PE, most notably during the first 3 months after PE diagnosis. However, those patients with abnormal VO2max at 1 year had less improvement over time and worse 1 year scores for all measures, compared to those with normal VO2max at 1 year. Further analyses will focus on identifying clinical, biomarker and imaging-based determinants of dyspnea, poor QOL and reduced walking capacity at 1 year after PE. Funding: Canadian Institutes of Health Research (MOP-93627) Figure 1. Figure 1. Disclosures Wells: BMS/Pfizer: Research Funding; Bayer: Honoraria.

scholarly journals Benefits of pulmonary rehabilitation in patients with advanced lymphangioleiomyomatosis (LAM) compared with COPD – a retrospective analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rainer Gloeckl ◽  
Christoph Nell ◽  
Tessa Schneeberger ◽  
Inga Jarosch ◽  
Martina Boensch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Therapeutic Option ◽  
Clinical Parameters ◽  
Walk Distance ◽  
Cystic Lung ◽  
Sf 36 ◽  
Effective Therapeutic Option ◽  
Registration Number

Abstract Lymphangioleiomyomatosis (LAM) is a rare and progressive cystic lung disease with limited therapeutic options. We retrospectively analyzed the effects of a comprehensive 4-week inpatient pulmonary rehabilitation (PR) program in 58 patients with advanced LAM (FEV1: 45 ± 34%predicted, 6-min walk distance (6MWD): 338 ± 167 m). Exercise performance (6MWD: + 49 ± 50 m; p < 0.001) and quality of life (SF-36 physical component: + 2.4 ± 7.8 points; p = 0.049 and mental component: + 5.2 ± 12.1 points; p < 0.001) increased significantly after PR comparable to an COPD cohort. There were no clinical parameters that predicted changes in outcomes following PR. PR seems to be an effective therapeutic option even in patients with advanced LAM. Trial registration Clinical-Trials registration number: NCT04184193; date of registration: December 3, 2019.

scholarly journals Quality of Life After Pulmonary Rehabilitation: Assessing Change Using Quantitative and Qualitative Methods

2000 ◽  
Vol 80 (10) ◽  
pp. 986-995 ◽  
Author(s):  
Pat G Camp ◽  
Jessica Appleton ◽  
W Darlene Reid
Keyword(s):  
Quality Of Life ◽  
Qualitative Research ◽  
Qualitative Methods ◽  
Physical Function ◽  
Pulmonary Rehabilitation ◽  
Short Form ◽  
Well Being ◽  
Sf 36 ◽  
Quantitative And Qualitative Methods

Abstract Background and Purpose. The purpose of this study was to use quantitative and qualitative research methods to evaluate quality-of-life (QOL) changes in patients with chronic obstructive pulmonary disease (COPD) after pulmonary rehabilitation. Subjects. Twenty-nine individuals with COPD (18 women and 11 men), with a mean age of 69 years (SD=8.6, range=53–92), participated. Methods. Subjects were assessed before and after a 5-week control phase and after a 5-week rehabilitation phase using the Chronic Respiratory Questionnaire (CRQ), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and spirometry. Our qualitative research was based on a subsample of 7 subjects who were interviewed after pulmonary rehabilitation. Results. Pulmonary rehabilitation improved QOL, as demonstrated by increases of 22% and 14% in the physical function categories of the CRQ and the SF-36, respectively, and by an increase of 10% in the CRQ's emotional function category. The qualitative data indicated how pulmonary rehabilitation influenced QOL. Conclusion and Discussion. The use of both quantitative and qualitative methods illustrated the nature of improvement in QOL after pulmonary rehabilitation. Improved physical function, less dyspnea, and a heightened sense of control over the subjects' COPD resulted in increased confidence and improved emotional well-being.

scholarly journals Impact of pulmonary rehabilitation on quality of life and functional capacity in patients on waiting lists for lung transplantation

2013 ◽  
Vol 39 (3) ◽  
pp. 349-356 ◽  
Author(s):  
Juliessa Florian ◽  
Adalberto Rubin ◽  
Rita Mattiello ◽  
Fabricio Farias da Fontoura ◽  
Jose de Jesus Peixoto Camargo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Lung Transplant ◽  
Waiting Lists ◽  
Rehabilitation Program ◽  
Sf 36 ◽  
The Mean ◽  
Pulmonary Rehabilitation Program ◽  
Minute Walk

OBJECTIVE: To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation. METHODS: Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures. RESULTS: Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47%) had pulmonary fibrosis, 13 (22%) had pulmonary emphysema, and 18 (31%) had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001), the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001), role-physical, up 10 (p = 0.045); vitality, up 10 (p < 0.001); social functioning, up 15 (p = 0.001); and mental health, up 8 (p = 0.001). CONCLUSIONS: Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.

scholarly journals Pulmonary rehabilitation to improve physical capacity, dyspnea and quality of life following pulmonary embolism (the PeRehab study): Study protocol for a two-centre randomized controlled trial

2020 ◽  
Author(s):  
Stacey Haukeland-Parker ◽  
Øyvind Jervan ◽  
Hege Hølmo Johannessen ◽  
Jostein Gleditsch ◽  
Knut Stavem ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Physical Capacity ◽  
Control Group ◽  
Walk Test ◽  
Randomized Controlled

Abstract Background: Recently, a large group of patients with persistent dyspnea, poor physical capacity and reduced health-related quality of life (HRQoL) following pulmonary embolism (PE) has been identified and clustered under the name “post pulmonary embolism syndrome” (PPS). These patients seem good candidates for pulmonary rehabilitation. The aim of the study is to explore whether a pulmonary rehabilitation program can improve physical capacity, dyspnea and HRQoL in PPS patients.Methods: A two-centre randomized controlled trial (RCT) is being performed at Østfold Hospital and Akershus University Hospital in Norway. Patients with PPS are 1:1 randomized into an intervention or a control group. The intervention consists of a supervised, outpatient rehabilitation program twice weekly (1 hour) for 8 weeks provided by experienced physiotherapists. The intervention involves individually adapted exercises based on existing pulmonary rehabilitation programs (relaxation, interval and resistance training), and an educational session including topics such as normal anatomy and physiology of the respiratory and circulatory system, information on PE/PPS, breathing strategies, and benefits of exercise/physical activity. Patients randomized to the control group receive usual care without specific instructions to exercise.Participants in the intervention and control groups will be compared based on assessments conducted at baseline, 12 weeks and 36 weeks after inclusion using the incremental shuttle walk test (primary outcome) and endurance shuttle walk test (exercise capacity), Sensewear activity monitor (daily physical activity), the Modified Medical Research Council scale, the Shortness of Breath questionnaire (dyspnea), and EQ-5D-5L and the Pulmonary Embolism Quality of Life Questionnaire (HRQoL).Recruitment of 190 patients is currently ongoing.Discussion: Results from this study may provide a currently untreated group of PPS patients with an effective treatment resulting in reduced symptoms of dyspnea, improved exercise capacity and better HRQoL following PE.Trial registration: NCT03405480, Clinical Trials (registered prospectively.Protocol version 1 (from original protocol September 2017).The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 1).

scholarly journals Improvement in 6-Minute Walking Distance after Supervised Exercise Training Is Related to Changes in Quality of Life in Patients with Lower Extremity Peripheral Artery Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3330
Author(s):  
Stefano Lanzi ◽  
Luca Calanca ◽  
André Berchtold ◽  
Lucia Mazzolai
Keyword(s):  
Quality Of Life ◽  
Exercise Training ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Walking Distance ◽  
Peripheral Artery ◽  
Supervised Exercise ◽  
Sf 36 ◽  
Artery Disease

This study aimed to investigate the relationship between supervised exercise training (SET)-induced changes in treadmill performance and 6 min walking distance, and changes in general (physical and mental) self-perceived health-related quality of life (HRQoL) in symptomatic patients with lower extremity peripheral artery disease (PAD). This is an observational study investigating Fontaine stage II PAD patients participating in 3-month SET. Before and following SET, treadmill performance (pain-free (PFWD) and maximal (MWD)), and 6 min walking distance (6MWD) were assessed. Self-perceived HRQoL was assessed with the Medical Outcomes Study Short-Form 36 (SF-36). Ankle- and toe-brachial indexes were also measured. One-hundred forty-seven patients with PAD were included (64.9 ± 9.6 y, 70% men). After SET, PFWD (+102%, p ≤ 0.001), MWD (+87%, p ≤ 0.001), and 6MWD (+14%, p ≤ 0.001) significantly increased. All eight SF-36 subscale scores significantly improved following SET (p ≤ 0.04). SET significantly improved physical and mental component summaries of the SF-36 (p ≤ 0.001). Larger increases in 6MWD were associated with greater improvements in physical (β = 0.19; p = 0.02) and mental (β = 0.24; p = 0.005) component summaries of the SF-36. No significant relationship was observed between changes in treadmill performance and changes in physical and mental component summaries of the SF-36. These results show that improvements in 6MWD following SET are related to improvements in general self-perceived HRQoL in patients with symptomatic lower extremity PAD. On the contrary, changes in treadmill performance were not related to improvements in HRQoL. These results suggest that the 6 min walking test is an essential outcome measure to assess overall patient functional status following interventions in patients with PAD.

scholarly journals Pulmonary rehabilitation to improve physical capacity, dyspnea and quality of life following pulmonary embolism (the PeRehab study): Study protocol for a two-centre randomized controlled trial.

2020 ◽  
Author(s):  
Stacey Haukeland-Parker ◽  
Øyvind Jervan ◽  
Hege Hølmo Johannessen ◽  
Jostein Gleditsch ◽  
Knut Stavem ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Physical Capacity ◽  
Control Group ◽  
Walk Test ◽  
Randomized Controlled

Abstract Background: Recently, a large group of patients with persistent dyspnea, poor physical capacity and reduced health-related quality of life (HRQoL) following pulmonary embolism (PE) has been identified and clustered under the name “post pulmonary embolism syndrome” (PPS). These patients seem good candidates for pulmonary rehabilitation. The aim of the study is to explore whether a pulmonary rehabilitation program can improve physical capacity, dyspnea and HRQoL in PPS patients.Methods: A two-centre randomized controlled trial (RCT) is being performed at Østfold Hospital and Akershus University Hospital in Norway. Patients with PPS are 1:1 randomized into an intervention or a control group. The intervention consists of a supervised, outpatient rehabilitation program twice weekly (1 hour) for 8 weeks provided by experienced physiotherapists. The intervention involves individually adapted exercises based on existing pulmonary rehabilitation programs (relaxation, interval and resistance training), and an educational session including topics such as normal anatomy and physiology of the respiratory and circulatory system, information on PE/PPS, breathing strategies, and benefits of exercise/physical activity. Patients randomized to the control group receive usual care without specific instructions to exercise. Participants in the intervention and control groups will be compared based on assessments conducted at baseline, 12 weeks and 36 weeks after inclusion using the incremental shuttle walk test (primary outcome) and endurance shuttle walk test (exercise capacity), Sensewear activity monitor (daily physical activity), the Modified Medical Research Council scale, the Shortness of Breath questionnaire (dyspnea), and EQ-5D-5L and the Pulmonary Embolism Quality of Life Questionnaire (HRQoL).Recruitment of 190 patients is currently ongoing.Discussion: Results from this study may provide a currently untreated group of PPS patients with an effective treatment resulting in reduced symptoms of dyspnea, improved exercise capacity and better HRQoL following PE.Trial registration: NCT03405480, Clinical Trials (registered prospectively.Protocol version 1 (from original protocol September 2017).The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 1).

Quality of life after pulmonary embolism as assessed with SF-36 and PEmb-QoL

2013 ◽  
Vol 132 (5) ◽  
pp. 500-505 ◽  
Author(s):  
Josien van Es ◽  
Paul L. den Exter ◽  
Ad A. Kaptein ◽  
Cornelie D. Andela ◽  
Petra M.G. Erkens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Sf 36
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