Satisfaction with Life and Adaptive Reactions in People Treated for Chronic Obstructive Pulmonary Disease

Author(s):  
Bartłomiej Drop ◽  
Mariola Janiszewska ◽  
Agnieszka Barańska ◽  
Krzysztof Kanecki ◽  
Aneta Nitsch-Osuch ◽  
...  
Author(s):  
N. P. Masik ◽  
S. V. Nechiporuk

Objective — to determine affects of the intermittent normobaric hypoxytherapy on the dynamics of general non‑specific adaptive reactions in the complex rehabilitation of patients with chronic obstructive pulmonary disease (COPD). Materials and methods. The treatment and examinations involved 450 patients with COPD, including GOLD 2 in 55.56 % (250 people) and GOLD 3 in 44.44 % (200 patients). The mean age was (52.65 ± 14.80) years, proportion of female and male subjects was equal. All patients received basic drug therapy according to the Order of MoH of Ukraine. The disease duration was 10 to 30 years, the remission stage was established in all patients. Patients were randomized into two groups: main (400 people) and control (50 people) with the same COPD severity distribution. Patients of the main group received additional 30 minutes sessions of interval normobaric hypoxytherapy for 20 days. The examination were performed for the dynamics of clinical symptoms, respiratory function, nonspecific resistance of an organism. Results. Most patients had symptoms of the disease against the background of basic COPD medication even on the remission stage. Unfavorable and intense adaptive reactions were determined in 71.33 % of COPD patients, and eustress reactions only in 16.89 %. Sanogenetic types of adaptive reactions were found in 28.45 % of subjects, maladaptive types — in 21.78 % of persons, pathogenetic — in 63.33 % of patients. At GOLD 2, tense reactions were diagnosed in 69.6 % of subjects, and in GOLD 3 in 73.0 %. As the severity of the disease increased, there was an increase in the development of intense training and activation responses. Upon completion of the course of hypoxytherapy, the exercise tolerance increased, and shortness of breath appeared only after severe physical activity in 90.25 % of patients in the main group, whereas in the control group similar changes were observed only in 20.0 % of patients. The respiratory function indicators in patients of the main group increased on average by 17.52 %, while in the control group — by 3.3 %. In the main group, favorable adaptation reactions prevailed in 88.25 % of patients, while in the control group this indicator was 32.0 %. The percentage of adverse reactions in the main group decreased significantly and was 11.75 % after treatment, the proportion of stress reactions — 46.25 %. In GOLD 2, the proportion of pathogenetic reactions decreased to 17.33 % and 56.00 % of the main and control groups, and in GOLD 3 — in 20.44 % and 44.0 %, respectively (p < 0.05). Conclusions. The use of a course of normobaric hypoxytherapy promoted the reduction of the main clinical COPD symptoms, increase of the frequency of favorable adaptive reactions up to 88.25 %, it raised clinical effectiveness of the treatment, which allowed to avoid disease exacerbations during the year in 80.95 % of patients.  


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


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