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COPD cardiac rehabilitation

Clément Medrinal, Guillaume Prieur, David Debeaumont, Aurora Robledo Quesada, Yann Combret, Jean Quieffin, Olivier Contal, Bouchra Lamia
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) has systemic repercussions that can lead to peripheral muscle dysfunction. Muscle atrophy reduces aerobic capacity, greatly limiting activities of daily living and quality of life. Pulmonary rehabilitation is the gold standard treatment for these patients, however, patients may not be able to reach sufficient training intensities for benefits to occur. Technologies such as functional electrical stimulation (FES) are currently being adapted and tested to enhance exercise training...
2016: BMJ Open Respiratory Research
Filip Jj Triest, Sally J Singh, Lowie Egw Vanfleteren
Patients with chronic obstructive pulmonary disease (COPD) who participate in pulmonary rehabilitation (PR) often have concomitant cardiovascular disease (CVD), which is a frequently undiagnosed and undertreated comorbidity. CVD contributes to the burden of the disease and is associated with an increased risk for hospitalizations and mortality. Optimizing the diagnosis and management of cardiovascular risk and disease should be considered as part of the holistic approach of PR. In addition, we need to consider similarities and differences in cardiac and PR programs, in order to improve personalized care in patients with both diseases...
August 2016: Chronic Respiratory Disease
William D-C Man, Faiza Chowdhury, Rod S Taylor, Rachael A Evans, Patrick Doherty, Sally J Singh, Sara Booth, Davey Thomason, Debbie Andrews, Cassie Lee, Jackie Hanna, Michael D Morgan, Derek Bell, Martin R Cowie
The study aimed to gain consensus on key priorities for developing breathlessness rehabilitation services for patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Seventy-four invited stakeholders attended a 1-day conference to review the evidence base for exercise-based rehabilitation in COPD and CHF. In addition, 47 recorded their views on a series of statements regarding breathlessness rehabilitation tailored to the needs of both patient groups. A total of 75% of stakeholders supported symptom-based rather than disease-based rehabilitation for breathlessness with 89% believing that such services would be attractive for healthcare commissioners...
August 2016: Chronic Respiratory Disease
Keisuke Miki, Ryoji Maekura, Masamitsu Nakazato, Nobuhiro Matsumoto, Seigo Kitada, Mari Miki, Kenji Yoshimura, Masahide Mori, Kenji Kangawa
OBJECTIVES: Ghrelin, a growth hormone-releasing peptide, has shown efficacy in chronic obstructive pulmonary disease (COPD) patients in previous trials. This study was designed to evaluate the effective dose of ghrelin in chronic respiratory failure patients. METHODS: In this randomized, double-blind, dose-finding, single-center study, 18 patients, including 16 with COPD, were randomly assigned to receive pulmonary rehabilitation (PR) with intravenous ghrelin at 1 μg/kg or 2 μg/kg, twice daily for 3 weeks...
August 10, 2015: Clinical Respiratory Journal
Catarina Santos, Fátima Rodrigues, Joana Santos, Luísa Morais, Cristina Bárbara
BACKGROUND: Exercise training is an important component of pulmonary rehabilitation, but it remains questionable how training intensity affects patient-centered outcomes. The aim of this study was to compare the effects of 2 aerobic training intensities on health-related quality of life (HRQOL), symptom control, and exercise tolerance in subjects with COPD. METHODS: Thirty-four subjects with mild to very severe COPD participated in an equivalence/non-inferiority randomized controlled trial with a parallel group blinded to 60 or 80% maximum work rate (W max) aerobic training intensity...
November 2015: Respiratory Care
I Nasis, E Kortianou, Μ Vasilopoulou, S Spetsioti, Z Louvaris, G Kaltsakas, C H Davos, S Zakynthinos, N G Koulouris, I Vogiatzis
Dynamic hyperinflation (DH) has a significant adverse effect on cardiovascular function during exercise in COPD patients. COPD patients with (n = 25) and without (n = 11) exercise-induced DH undertook an incremental (IET) and a constant-load exercise test (CLET) sustained at 75% peak work (WRpeak) prior to and following an interval cycling exercise training regime (set at 100% WRpeak with 30-s work/30-s rest intervals) lasting for 12 weeks. Cardiac output (Q) was assessed by cardio-bio-impedance (PhysioFlow, enduro, PF-O7) to determine Q mean response time (QMRT) at onset (QMRT(ON)) and offset (QMRT(OFF)) of CLET...
October 2015: Respiratory Physiology & Neurobiology
Francesco Giallauria, Francesco Fattirolli, Roberto Tramarin, Marco Ambrosetti, Raffaele Griffo, Carmine Riccio, Stefania De Feo, Massimo Francesco Piepoli, Carlo Vigorito
BACKGROUND: Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of Cardiac Rehabilitation (CR) in patients with diabetes. METHODS: Data from 165 CR units were collected online from January 28th to February 10th, 2008. RESULTS: The study cohort consisted of 2281 patients (66.9 ± 12 yrs); 475 (69.7 ± 10 yrs, 74% male) patients with diabetes and 1806 (66.2 ± 12 yrs, 72% male) non-diabetic patients...
February 2015: Diabetes Research and Clinical Practice
M Dahdah, S Barnes, K Schmidt, A Buros, R Dubiel, C Dunklin, L Callender, S Shafi
OBJECTIVE: To determine the impact of preexisting illness on inpatient rehabilitation outcomes in patients with TBI. METHOD: Retrospective analysis of prospectively collected data from a TBI Model System Center, inpatient rehabilitation center. Participants included 132 TBI survivors aged ≥ 16. OUTCOME MEASURES: FIM total score and DRS at discharge, Trail Making Test A (TMT: A), Trail Making Test B (TMT: B), and Total Trials 1-5 of California Verbal Learning Test, 2nd Edition (CVLT-II)...
September 2014: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Maureen Davey, Wendy Moore, Julia Walters
BACKGROUND: Although the burden of cardiopulmonary diseases in the Aboriginal community is high, utilisation of rehabilitation services has been poor. We evaluated the uptake and effectiveness of a cardiovascular and pulmonary rehabilitation program specifically designed and provided for the Aboriginal community, by the Tasmanian Aboriginal Centre, for people with diagnosed chronic heart or respiratory disease and those at high risk of developing such conditions. METHODS: Participants had established chronic obstructive pulmonary disease, ischaemic heart disease or chronic heart failure or were at high risk of developing such diseases because of multiple risk factors...
2014: BMC Health Services Research
Alexandra Marie Nanzer, John Janssen, Matthew Hind
A 78-year-old man presented with severe exertional dyspnoea. He suffered from mild chronic obstructive pulmonary disease, congestive cardiac failure and seropositive myasthaenia gravis. Clinical examination of his chest and heart were unremarkable but he had speech dyspnoea and was unable to count to 20 in a single breath. Consecutive sniff nasal inspiratory measurements (SNIP) fell from 55 to 33 cm H2O and forced vital capacity (FVC) fell from 3.4 to 2.4 L. A diagnosis of myasthenic crisis was carried out and treatment with non-invasive ventilation, intravenous immunoglobulis and high-dose oral prednisolone was initiated...
2014: BMJ Case Reports
Denis E O'Donnell, Kevin B Gebke
Dyspnea, exercise intolerance, and activity restriction are already apparent in mild chronic obstructive pulmonary disease (COPD). However, patients may not seek medical help until their symptoms become troublesome and persistent and significant respiratory impairment is already present; as a consequence, further sustained physical inactivity may contribute to disease progression. Ventilatory and gas exchange impairment, cardiac dysfunction, and skeletal muscle dysfunction are present to a variable degree in patients with mild COPD, and collectively may contribute to exercise intolerance...
2014: International Journal of Chronic Obstructive Pulmonary Disease
Rachael A Evans, Michael D L Morgan
The systemic effects and comorbidities of chronic respiratory disease such as COPD contribute substantially to its burden. Symptoms in COPD do not solely arise from the degree of airflow obstruction as exercise limitation is compounded by the specific secondary manifestations of the disease including skeletal muscle impairment, osteoporosis, mood disturbance, anemia, and hormonal imbalance. Pulmonary rehabilitation targets the systemic manifestations of COPD, the causes of which include inactivity, systemic inflammation, hypoxia and corticosteroid treatment...
June 2014: Clinics in Chest Medicine
Eva Zupanic, Ina Zivanovic, Jurij Matija Kalisnik, Viktor Avbelj, Mitja Lainscak
Chronic obstructive pulmonary disease negatively affects the autonomic nervous system and increases risks of arrhythmias and sudden cardiac death. Electrocardiogram (ECG) recordings were used to compare parameters of heart rate variability and QTc interval in patients with COPD and healthy individuals. The effects of a 4-week program of rehabilitation in patients with COPD were also evaluated by comparing pre- and post-rehabilitation ECGs with age- and sex-matched control COPD patients not participating in the program...
December 2014: COPD
Stefan Tino Kulnik, Gerrard Francis Rafferty, Surinder S Birring, John Moxham, Lalit Kalra
BACKGROUND: After stroke, pneumonia is a relevant medical complication that can be precipitated by aspiration of saliva, liquids, or solid food. Swallowing difficulty and aspiration occur in a significant proportion of stroke survivors. Cough, an important mechanism protecting the lungs from inhaled materials, can be impaired in stroke survivors, and the likely cause for this impairment is central weakness of the respiratory musculature. Thus, respiratory muscle training in acute stroke may be useful in the recovery of respiratory muscle and cough function, and may thereby reduce the risk of pneumonia...
2014: Trials
Shih-Tsung Cheng, Yao-Kuang Wu, Mei-Chen Yang, Chun-Yao Huang, Hui-Chuan Huang, Wen-Hua Chu, Chou-Chin Lan
OBJECTIVE: Patients with chronic obstructive pulmonary disease (COPD) appear to have impaired cardiac autonomic modulation with depressed heart rate variability (HRV). Pulmonary rehabilitation (PR) is recommended as an integral part of the management. However, the effect of PR on HRV at peak exercise remains unclear. METHODS: Sixty-four patients with COPD participated in a 12-week, 2 sessions-per-week, hospital-based PR program. Baseline and post-PR status were evaluated by spirometry, HRV, health-related quality of life (HRQL, St...
May 2014: Heart & Lung: the Journal of Critical Care
P Solidoro, M Boffini, D Lacedonia, N Scichilone, G Paciocco, F DI Marco
The prevalence of pulmonary hypertension (PH) in the general chronic obstructive pulmonary disease (COPD) population is undefined because stable COPD patients do not routinely undergo screening echocardiogram and right heart catheterization. Most studies published on this topic are focused on a highly selected group of patients with moderate to severe disease awaiting lung transplantation, since hemodynamic data from cardiac catheterization are part of the standard transplant evaluation. In a very recent article, Hurdman et al...
February 2014: Minerva Medica
A Borghi-Silva, R G Mendes, R Trimer, C R Oliveira, G A Fregonezi, V R Resqueti, R Arena, L M Sampaio-Jorge, D Costa
BACKGROUND: Exercise is an important part of chronic obstructive pulmonary disease (COPD) treatment. However, it is not know about the minimum effective time of physical training that could beneficially modify the cardiac autonomic modulation (CAM) and exercise capacity in these patients. AIM: To contrast the potential effects of a physical training program (PTP), for 6 versus 12 weeks, on CAM by linear and nonlinear heart rate variability (HRV) indices and exercise capacity in COPD patients...
April 2015: European Journal of Physical and Rehabilitation Medicine
Verônica F Parreira, Tania Janaudis-Ferreira, Rachel A Evans, Sunita Mathur, Roger S Goldstein, Dina Brooks
Background: The incremental shuttle walk test (ISWT) was developed > 20 years ago and has been used to assess peak exercise capacity in a variety of chronic diseases. The aim of this systematic review is to describe the measurement properties of the ISWT in a clinical population.Methods: Of 800 articles identified by electronic and hand searches, 35 were included. Twenty-one articles included data on the validity of the ISWT, 18 on the reliability, four on the responsiveness,and four on the interpretability...
June 2014: Chest
Marco Ambrosetti, Pier Luigi Temporelli, Pompilio Faggiano, Oreste Febo, Tommaso Diaco, Giuseppe Favretto, Pasqualina Calisi, Michele Gabriele, Cesare Greco, Luigi Tavazzi
BACKGROUND/OBJECTIVES: Lower extremities peripheral arterial disease (LE-PAD) across the wide range of conditions for Cardiac Rehabilitation (CR) is poorly understood. The "ATHerosclerosis of the lower extremIties as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation" (THINKPAD) registry explored LE-PAD in CR patients in terms of prevalence and interventions delivered. METHODS: Multicenter, consecutive case series of 1506 patients discharged from 16 CR Units in Italy from May 1 to June 30, 2012...
February 1, 2014: International Journal of Cardiology
Daniela Gologanu, Cristina Stanescu, Teodora Ursica, Marius I Balea, Diana Ionita, Miron Alexandru Bogdan
ABSTRACT: HASH(0x52fd920) OBJECTIVES: Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmo-nary disease (COPD); its prevalence is currently unknown. The objectives of the study were: (a) to provide data on the prevalence of PH among the COPD patients referred to a pulmonary rehabilitation program; (b) to evaluate possible correlations of PH with the severity of COPD, the presence of hypoxemia and polycythemia. MATERIAL AND METHODS: We retrospectively studied 31 consecutive patients with the diagnosis of COPD hospitalised in our clinic in which echocardiography was performed...
September 2013: Mædica
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