1,721,222 research outputs found
Alternative Modes of Delivery in Pulmonary Rehabilitation
No full textPurpose:This review presents an overview of the safety and efficacy of alternative modes of pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease (COPD).Review Methods:We identified recently published systematic reviews, meta-analyses, and guidelines, as well as relevant studies, exploring the safety and effectiveness of community-based PR, home-based PR, telerehabilitation, and web-based rehabilitation in people with COPD. A narrative summary of the main findings is presented.Summary:Although evidence suggests that community-based PR, home-based PR, telerehabilitation, and web-based rehabilitation are effective alternatives to center-based PR, it requires a careful interpretation as several of these programs do not comply with PR definition and have been compared with center-based PR programs that do not reach the minimal clinically important differences. Moreover, there is a huge heterogeneity among programs, and the confidence and quality of the evidence is mostly low. Hence, these novel modes of PR and center-based PR are not interchangeable. Instead, these are alternative modes aiming to increase access to PR. Questions remain regarding the most efficient way of implementing each PR mode, level of access, reimbursement policies, and data privacy in the use of technology. Standard protocols on how to set up each alternative PR mode need to be developed. Future research needs to explore how to use the treatable traits approach in combination with individual preferences and needs, program availability, safety, social support network, digital literacy, and health system context to identify the optimal PR program for each patient
Cognitive, psychological and physical functioning in post COVID-19 patients with different levels of fatigue: a descriptive abstract
No full textBackground: Recent studies have shown that a growing number of mild COVID-19 cases experience prolonged symptoms, reporting a range of disabling symptoms such as fatigue, shortness of breath, cognitive impairment, memory loss, and mental health and employment issues up to months following the infection. This has recently been accounted for by the World Health Organization, which has defined post COVID-19 as a condition that usually occurs three months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. A data-driven identification of subgroups of post COVID-19 could help in referring this clinically heterogeneous group of patients to the appropriate care. However, most of the evidence has been obtained through self-reported and retrospective surveys, lacking in-person monitoring and assessment of cognitive, physical, and …Voor extra info [email protected]
Giving voice to people: experiences during mild to moderate acute exacerbations of COPD
Full text linkAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) have a negative impact on health status and disease progression, but their clinical presentation is heterogenous. A comprehensive understanding of people's experience during AECOPD is needed to develop person-centred interventions, such as pulmonary rehabilitation (PR). This study aimed to explore people's experience during mild to moderate AECOPD, and their thoughts on PR during this period.publishe
Extra-pulmonary manifestations of COPD and the role of pulmonary rehabilitation: a symptom-centered approach
No full textIntroduction: Chronic obstructive pulmonary disease (COPD) is a complex and heterogenous disease that is associated with a range of respiratory and non-respiratory symptoms, which highly contribute to the daily burden of the disease. Symptoms burden remains high despite optimal bronchodilator therapy, but pulmonary rehabilitation (PR) is an effective intervention to improve patients' symptoms. A comprehensive interdisciplinary approach within the framework of a PR program is warranted to tackle these complex symptoms and their consequences. Areas covered: This narrative review describes how symptoms of dyspnea, fatigue, cough, sputum, anxiety, depression, pain, sleep disturbances, and cognitive decline arise in COPD and can contribute to several non-pulmonary manifestations of the disease. It also describes evidence of the effectiveness of interdisciplinary PR programs to counteract these symptoms. A literature search was performed on PubMed and Scopus between June and July 2020. Expert opinion: Respiratory and non-respiratory symptoms are highly prevalent, often not comprehensively assessed, and result in several extra-pulmonary manifestations of the disease (physical, emotional and social). Interdisciplinary PR programs can improve these negative manifestations through different pathways, contributing for an effective symptoms' management. A thorough assessment of symptoms (beyond dyspnea) should be routinely performed and may support the identification of treatable traits, allowing the tailoring of PR interventions and assessment of their real-life impact.publishe
Effects of Physical Activity and Exercise Interventions on Health Outcomes in Occupational Drivers: A Systematic Review
No full textBackground: Occupational drivers are exposed to a wide range of risk factors, including sedentary behavior and physical inactivity, which can contribute to various chronic diseases. However, exercise interventions are likely to alleviate the negative associations and reduce chronic disease risks. This systematic review aimed to inventorize research studies investigating the effects of physical activity and exercise interventions on health outcomes in occupational drivers, and to assess interventions that have demonstrated effectiveness on health outcomes in occupational drivers.Methods: The electronic databases "Web of Science," "Scopus," and "PubMed" were searched using keywords related to "occupational drivers," "exercise," and "health outcomes." Studies were included if they examined the effects of physical activity and exercise among occupational drivers on the following health outcomes: pain, disability, lifestyle factors (sleep, weight, physical activity, nutrition), fatigue, stress, and cardiometabolic risk factors. The methodological quality of the studies was assessed by the Cochrane Risk of Bias tools for randomized and non-randomized studies.Results: Fourteen articles were included (three randomized and 11 non-randomized controlled trials). All studies were judged to have an overall risk of bias as "some concerns, low, moderate or serious." Evidence suggests that stretching and isometric exercises have significantly improved pain, disability, and fatigue. In contrast, multicomponent lifestyle interventions have enhanced physical activity levels, cardiometabolic risk factors, anthropometrics (body mass index, weight, waist circumference), sleep, and dietary intake among occupational drivers.Conclusion: The available evidence indicates the potential benefits of exercise interventions and physical activity for health outcomes in occupational drivers. However, high-quality studies are needed in the future to establish stronger evidence supporting the effect of the exercise intervention.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by Higher Education Commission of Pakistan (HEC), Grant No. HEC/HRD/OSS-III/ Batch-3/Belgium/2022/19745
Effects of Home- based Pulmonary Rehabilitation on the Symptoms of People With Exacerbations of COPD: A Mixed-methods Randomized Controlled Trial
No full textDo pulmonary rehabilitation programmes improve outcomes in patients with COPD posthospital discharge for exacerbation: a systematic review and meta-analysis
No full textIntroduction Previous systematic reviews have provided heterogeneous and differing estimates for the efficacy of pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease (COPD). The aim of this review was to examine the efficacy of pulmonary rehabilitation programmes initiated within 3 weeks of hospital discharge following an exacerbation of COPD.Methods An update of a previous Cochrane review was undertaken using the Cochrane Airways Review Group Specialised Register. Searches were conducted from October 2015 to August 2023 for studies that initiated pulmonary rehabilitation within 3 weeks of hospital discharge. Studies assessing the impact of solely inpatient pulmonary rehabilitation were excluded. Forest plots were generated using a generic inverse variance random effects method.Results Seventeen studies were included. Posthospital discharge pulmonary rehabilitation reduced hospital re-admissions (OR 0.48, 95% CI 0.30 to 0.77, I2=67%), improved exercise capacity (6 min walk test, mean difference (MD) 57 m, 95% CI 29 to 86, I2=89%; incremental shuttle walk test, MD 43 m, 95% CI 6 to 79, I2=81%), health-related quality of life (St. George's Respiratory Questionnaire, MD -8.7 points, 95% CI -12.5 to -4.9, I2=59%; Chronic Respiratory Disease Questionnaire (CRQ)-emotion, MD 1.0 points, 95% CI 0.4 to 1.6, I2=74%; CRQ-fatigue, MD 0.9 points, 95% CI 0.1 to 1.6, I2=91%), and dyspnoea (CRQ-dyspnoea, MD 1.0 points, 95% CI 0.3 to 1.7, I2=87%; modified Medical Research Council Dyspnoea Scale, MD -0.3 points, 95% CI -0.5 to -0.1, I2=60%). Significant effects were not observed for CRQ-mastery, COPD assessment test, EuroQol-5 Dimension-5 Level and mortality. No intervention-related adverse events were reported.Discussion Pulmonary rehabilitation delivered posthospital discharge for exacerbation of COPD results in a reduction in hospital re-admissions and improvements in exercise capacity, health-related quality of life and dyspnoea in the absence of any intervention-related adverse events.Trial registration number CRD42023406397.This review was funded by the American Thoracic Society as part of a clinical practice guideline
Patients' and physiotherapists' perspectives on most relevant treatable traits of functioning in patients with severe exacerbation of CCPD: An international survey
No full textUnveiling barriers and Facilitators to physical activity: Exploring physical activity, sedentary behavior, and health outcomes among occupational drivers in Pakistan
No full textDeterminants Of Peak Aerobic Capacity And Six-Minute Walk Distance In Patients Treated For Lung Cancer
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