BACKGROUND The prevalence of chronic obstructive pulmonary disease(COPD)is increasing worldwide,and at the same time it is associated with increased mortality and reduced quality of life.Efforts to build sustainable r...BACKGROUND The prevalence of chronic obstructive pulmonary disease(COPD)is increasing worldwide,and at the same time it is associated with increased mortality and reduced quality of life.Efforts to build sustainable rehabilitation approaches to COPD treatment and prevention are crucial.The system of long-term pulmonary rehabilitation care is insufficient.The main reasons for the absence of these outpatient programs are the lack of experience,the lack of interest of insurance companies in secondary prevention programs,and the lack of healthcare facilities in large geographical areas.The possibility of at-home pulmonary rehabilitation models(telemonitoring and telecoaching)could solve this problem.CASE SUMMARY A 71-year-old man with severe COPD,Global Initiative for Obstructive Lung Diseases stage 3 underwent an 8-wk remotely monitored inspiratory muscle training with a device based on the test of incremental respiratory endurance method.Spirometry,body plethysmography,test of incremental respiratory endurance examination,6-min walking test,body mass index,airflow obstruction,dyspnea,exercise capacity index,and subjective perception of dyspnea were performed as part of the initial and final examination.The patient performed training at home,and the physiotherapist monitored the patient remotely through a web application that allowed the physiotherapist to evaluate all training parameters in real-time and respond to any problems.After 8 wk of home training,there was a significant increase in all monitored values:maximal inspiratory pressure,a novel parameter sustained maximal inspiratory pressure,forced expiratory volume in 1 s,total lung capacity,forced vital capacity,peak expiratory flow,and inspiratory capacity.There was also an improvement in the perception of dyspnea according to the COPD Assessment Test and a modified Medical Research Council Breathlessness Scale,an increase in exercise tolerance according to the 6-min walking test,and a decrease in the exercise capacity index as a predictor of prognosis.CONCLUSION Respiratory telerehabilitation was greatly beneficial in a cooperative patient with COPD and may represent an alternative therapeutic approach to the increasing incidence of all lung diseases.展开更多
BACKGROUND Lung resection represents the main curative treatment modality of non-small cell lung cancer.Patients with high-risk to develop postoperative pulmonary complications have been classified as“high-risk patie...BACKGROUND Lung resection represents the main curative treatment modality of non-small cell lung cancer.Patients with high-risk to develop postoperative pulmonary complications have been classified as“high-risk patients.”Characterizing this population could be important to improve their approach and rehabilitation.AIM To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization.METHODS A longitudinal observational prospective cohort study was carried out.Patients undergoing lung resection were recruited from the“Hospital Virgen de las Nieves”(Granada)and divided into two groups according to the risk profile criteria(age≥70 years,forced expiratory volume in 1 s≤70%predicted,carbon monoxide diffusion capacity≤70%predicted or scheduled pneumonectomy).Outcomes included were exercise capacity(Fatigue Severity Scale,Unsupported Upper-Limb Exercise,handgrip dynamometry,Five Sit-to-stand test,and quadriceps hand-held dynamometry)and patient-reported outcome(Euroqol-5 dimensions 5 Levels Visual Analogue Scale).RESULTS In total,115 participants were included in the study and divided into three groups:high-risk,low-risk and control group.At discharge high-risk patients presented a poorer exercise capacity and a worse self-perceived health status(P<0.05).One month after discharge patients in the high-risk group maintained these differences compared to the other groups.CONCLUSION Our results show a poorer recovery in high-risk patients at discharge and 1 mo after surgery,with lower self-perceived health status and a poorer upper and lower limb exercise capacity.These results are important in the rehabilitation field.展开更多
基金Ministry of Health of the Czech Republic(University Hospital Brno,65269705),No.NU21J-09-00004.
文摘BACKGROUND The prevalence of chronic obstructive pulmonary disease(COPD)is increasing worldwide,and at the same time it is associated with increased mortality and reduced quality of life.Efforts to build sustainable rehabilitation approaches to COPD treatment and prevention are crucial.The system of long-term pulmonary rehabilitation care is insufficient.The main reasons for the absence of these outpatient programs are the lack of experience,the lack of interest of insurance companies in secondary prevention programs,and the lack of healthcare facilities in large geographical areas.The possibility of at-home pulmonary rehabilitation models(telemonitoring and telecoaching)could solve this problem.CASE SUMMARY A 71-year-old man with severe COPD,Global Initiative for Obstructive Lung Diseases stage 3 underwent an 8-wk remotely monitored inspiratory muscle training with a device based on the test of incremental respiratory endurance method.Spirometry,body plethysmography,test of incremental respiratory endurance examination,6-min walking test,body mass index,airflow obstruction,dyspnea,exercise capacity index,and subjective perception of dyspnea were performed as part of the initial and final examination.The patient performed training at home,and the physiotherapist monitored the patient remotely through a web application that allowed the physiotherapist to evaluate all training parameters in real-time and respond to any problems.After 8 wk of home training,there was a significant increase in all monitored values:maximal inspiratory pressure,a novel parameter sustained maximal inspiratory pressure,forced expiratory volume in 1 s,total lung capacity,forced vital capacity,peak expiratory flow,and inspiratory capacity.There was also an improvement in the perception of dyspnea according to the COPD Assessment Test and a modified Medical Research Council Breathlessness Scale,an increase in exercise tolerance according to the 6-min walking test,and a decrease in the exercise capacity index as a predictor of prognosis.CONCLUSION Respiratory telerehabilitation was greatly beneficial in a cooperative patient with COPD and may represent an alternative therapeutic approach to the increasing incidence of all lung diseases.
文摘BACKGROUND Lung resection represents the main curative treatment modality of non-small cell lung cancer.Patients with high-risk to develop postoperative pulmonary complications have been classified as“high-risk patients.”Characterizing this population could be important to improve their approach and rehabilitation.AIM To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization.METHODS A longitudinal observational prospective cohort study was carried out.Patients undergoing lung resection were recruited from the“Hospital Virgen de las Nieves”(Granada)and divided into two groups according to the risk profile criteria(age≥70 years,forced expiratory volume in 1 s≤70%predicted,carbon monoxide diffusion capacity≤70%predicted or scheduled pneumonectomy).Outcomes included were exercise capacity(Fatigue Severity Scale,Unsupported Upper-Limb Exercise,handgrip dynamometry,Five Sit-to-stand test,and quadriceps hand-held dynamometry)and patient-reported outcome(Euroqol-5 dimensions 5 Levels Visual Analogue Scale).RESULTS In total,115 participants were included in the study and divided into three groups:high-risk,low-risk and control group.At discharge high-risk patients presented a poorer exercise capacity and a worse self-perceived health status(P<0.05).One month after discharge patients in the high-risk group maintained these differences compared to the other groups.CONCLUSION Our results show a poorer recovery in high-risk patients at discharge and 1 mo after surgery,with lower self-perceived health status and a poorer upper and lower limb exercise capacity.These results are important in the rehabilitation field.
