scholarly journals Reduction in hospitalisation following pulmonary rehabilitation in patients with COPD

2008 ◽  
Vol 32 (3) ◽  
pp. 415 ◽  
Author(s):  
Nola Cecins ◽  
Elizabeth Geelhoed ◽  
Sue C Jenkins
Keyword(s):  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Hospital Admissions ◽  
Chronic Respiratory Disease ◽  
Health Care Utilisation ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Chronic Respiratory Disease Questionnaire ◽  
Number Of Patients ◽  
Bed Days

Objectives: Pulmonary rehabilitation (PR) improves exercise capacity and health-related quality of life (HRQoL), and reduces health care utilisation. This study quantified outcomes of a PR program over a 6-year period and determined the effects of PR on hospitalisation. Methods: Patients with chronic obstructive pulmonary disesae (COPD) who entered an 8-week outpatient PR program from 1998 to 2003 were included. Functional exercise capacity (6-minute walk distance [6MWD]) and HRQoL (Chronic Respiratory Disease Questionnaire) were measured before and following PR. The number of hospital admissions and total bed-days due to a COPD exacerbation in the 12 months before and following PR were recorded. Setting: Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia. Results: 187 (73%) of the 256 patients who entered PR completed the program. Improvements in 6MWD (404.2 �114.6 m to 439.6 �115.0m, P < 0.001) and HRQoL (4.1 �0.9 points per item to 4.9 �0.9 points per item, P < 0.001) occurred following PR. There was a 46% reduction in the number of patients admitted to hospital (71 to 38) with a COPD exacerbation and a 62% reduction in total bed-days (1131 to 432) following PR. Conclusion: Pulmonary rehabilitation provided in an Australian teaching hospital was associated with a reduction in COPD hospitalisation, and the resultant savings outweighed the costs of providing the program.

scholarly journals Pulmonary rehabilitation in bronchiectasis: a propensity-matched study

2018 ◽  
Vol 53 (1) ◽  
pp. 1801264 ◽  
Author(s):  
Suhani Patel ◽  
Aaron D. Cole ◽  
Claire M. Nolan ◽  
Ruth E. Barker ◽  
Sarah E. Jones ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Real Life ◽  
Chronic Respiratory Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Completion Rates ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Disease Questionnaire ◽  
Real Life Data ◽  
Matched Study

International guidelines recommend pulmonary rehabilitation for patients with bronchiectasis, supported by small trials and data extrapolated from chronic obstructive pulmonary disease (COPD). However, it is unknown whether real-life data on completion rates and response to pulmonary rehabilitation are similar between patients with bronchiectasis and COPD.Using propensity score matching, 213 consecutive patients with bronchiectasis referred for a supervised pulmonary rehabilitation programme were matched 1:1 with a control group of 213 patients with COPD. Completion rates, change in incremental shuttle walk (ISW) distance and change in Chronic Respiratory Disease Questionnaire (CRQ) score with pulmonary rehabilitation were compared between groups.Completion rate was the same in both groups (74%). Improvements in ISW distance and most domains of the CRQ with pulmonary rehabilitation were similar between the bronchiectasis and COPD groups (ISW distance: 70 versus 63 m; CRQ-Dyspnoea: 4.8 versus 5.3; CRQ-Emotional Function: 3.5 versus 4.6; CRQ-Mastery: 2.3 versus 2.9; all p>0.20). However, improvements in CRQ-Fatigue with pulmonary rehabilitation were greater in the COPD group (bronchiectasis 2.1 versus COPD 3.3; p=0.02).In a real-life, propensity-matched control study, patients with bronchiectasis show similar completion rates and improvements in exercise and health status outcomes as patients with COPD. This supports the routine clinical provision of pulmonary rehabilitation to patients with bronchiectasis.

Pulmonary rehabilitation

2003 ◽  
Vol 13 (3) ◽  
pp. 175-182 ◽  
Author(s):  
Dipankar Dutta ◽  
Richard JA Butland ◽  
Ruma R Dutta ◽  
Miriam C Casey
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Exercise Programme ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Multidisciplinary Education ◽  
Programme Of Care

Pulmonary rehabilitation is a multidisciplinary education and exercise programme of care for patients with chronic respiratory disease, particularly Chronic Obstructive Pulmonary Disease (COPD). It aims to reduce symptoms, decrease disability, increase participation in physical and social activities and improve overall quality of life in patients who may still be very disabled despite optimal pharmacological treatment. Pulmonary rehabilitation first began more than 30 years ago and is now established as an important part of the management of COPD.

scholarly journals Hospitalisation for COPD in Puglia: the role of hospital discharge database to estimate prevalence and incidence

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
P. Trerotoli ◽  
N. Bartolomeo ◽  
A.M. Moretti
Keyword(s):  
Disease Management ◽  
Hospital Discharge ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Diagnostic Procedures ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
Hospital Discharge Database ◽  
Discharge Database

Background and aim. Chronic Obstructive Pulmonary Disease (COPD), although largely preventable, is a great health burden in all the countries worldwide. Statistics of morbidity and mortality of COPD show the need for correct management of the disease. Chronic Obstructive Respiratory Diseases (DRG 88) are in 9th place for discharge in in-patient hospital admission. It is necessary to establish specific indicators which are efficacious and relevant for the patient, the doctor and the health manager. This study will analyse the information in respect of hospital admissions (Hospital discharge database) in Puglia for the period 2000-2005. Methods. The analysis was carried out utilising the Puglia Region hospital patient discharge database, selecting those patients with admission for chronic respiratory disease as principal or secondary diagnosis. Results. Chronic respiratory diseases are more frequent in males and in people over 45 years old with frequency increasing with age. Geographical distribution shows that there are greater rates of hospitalisation in big cities and in the neighbourhood of industrial areas. Although the trend over time is slight. A higher percentage of re-admission has been found for patients with COPD, and the interval between the two admissions occurs within one or two months; the diagnosis at the second admission is the same as for the first. 10.6% of discharge forms report one diagnosis, especially in patients older than 65 years of age. Little could be said about diagnostic procedures because these are not reported on the discharge form. Conclusion. Hospitalisation data confirms expectations regarding age and sex of patients. The high hospitalisation rates indicate that in-patients care still remains the only viable treatment for COPD and other chronic respiratory diseases. The high number of exacerbations reflect the absence of out-patients service or community care, and the same diagnosis in more than one episode shows the lack of efficiency of health services and disease management. This data is necessary to understand disease distribution and the modification of disease management in order to reduce health care costs, to increase efficacy in disease control and to limit repeated exacerbation and so to obtain the maximum benefit for the patients.

scholarly journals A home-based pulmonary rehabilitation mHealth system to enhance the exercise capacity of patients with COPD: development and evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ning Deng ◽  
Leiyi Sheng ◽  
Wangshu Jiang ◽  
Yongfa Hao ◽  
Shuoshuo Wei ◽  
...  
Keyword(s):  
Behavior Change ◽  
Technology Acceptance ◽  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Exercise Prescription ◽  
Chronic Obstructive ◽  
Pilot Studies ◽  
Home Based ◽  
Copd Patients ◽  
Significant Difference

Abstract Background Patients with chronic obstructive pulmonary disease (COPD) experience deficits in exercise capacity and physical activity as their disease progresses. Pulmonary rehabilitation (PR) can enhance exercise capacity of patients and it is crucial for patients to maintain a lifestyle which is long-term physically active. This study aimed to develop a home-based rehabilitation mHealth system incorporating behavior change techniques (BCTs) for COPD patients, and evaluate its technology acceptance and feasibility. Methods Guided by the medical research council (MRC) framework the process of this study was divided into four steps. In the first step, the prescription was constructed. The second step was to formulate specific intervention functions based on the behavior change wheel theory. Subsequently, in the third step we conducted iterative system development. And in the last step two pilot studies were performed, the first was for the improvement of system functions and the second was to explore potential clinical benefits and validate the acceptance and usability of the system. Results A total of 17 participants were enrolled, among them 12 COPD participants completed the 12-week study. For the clinical outcomes, Six-Minute Walk Test (6MWT) showed significant difference (P = .023) over time with an improvement exceeded the minimal clinically important difference (MCID). Change in respiratory symptom (CAT score) was statistically different (P = .031) with a greater decrease of − 3. The mMRC levels reduced overall and showed significant difference. The overall compliance of this study reached 82.20% (± 1.68%). The results of questionnaire and interviews indicated good technology acceptance and functional usability. The participants were satisfied with the mHealth-based intervention. Conclusions This study developed a home-based PR mHealth system for COPD patients. We showed that the home-based PR mHealth system incorporating BCTs is a feasible and acceptable intervention for COPD patients, and COPD patients can benefit from the intervention delivered by the system. The proposed system played an important auxiliary role in offering exercise prescription according to the characteristics of patients. It provided means and tools for further individuation of exercise prescription in the future.

scholarly journals Exercise-Based Rehabilitation Delivery Models in Comorbid Chronic Pulmonary Disease and Chronic Heart Failure

2021 ◽  
Vol 8 ◽  
Author(s):  
Audrey Borghi-Silva ◽  
Adriana S. Garcia-Araújo ◽  
Eliane Winkermann ◽  
Flavia R. Caruso ◽  
Daniela Bassi-Dibai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Pulmonary Disease ◽  
Exercise Capacity ◽  
Aging Process ◽  
Hospital Admissions ◽  
Negative Impact ◽  
Hospital Readmissions ◽  
Chronic Obstructive ◽  
Delivery Models

Among the most prevalent multimorbidities that accompany the aging process, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) stand out, representing the main causes of hospital admissions in the world. The prevalence of COPD coexistence in patients with CHF is higher than in control subjects, given the common risk factors associated with a complex process of chronic diseases developing in the aging process. COPD-CHF coexistence confers a marked negative impact on mechanical-ventilatory, cardiocirculatory, autonomic, gas exchange, muscular, ventilatory, and cerebral blood flow, further impairing the reduced exercise capacity and health status of either condition alone. In this context, integrated approach to the cardiopulmonary based on pharmacological optimization and non-pharmacological treatment (i.e., exercise-based cardiopulmonary and metabolic rehabilitation) can be emphatically encouraged by health professionals as they are safe and well-tolerated, reducing hospital readmissions, morbidity, and mortality. This review aims to explore aerobic exercise, the cornerstone of cardiopulmonary and metabolic rehabilitation, resistance and inspiratory muscle training and exercise-based rehabilitation delivery models in patients with COPD-CHF multimorbidities across the continuum of the disease. In addition, the review address the importance of adjuncts to enhance exercise capacity in these patients, which may be used to optimize the gains obtained in these programs.

Effects of neuromuscular electrical stimulation on exercise capacity, muscle strength and quality of life in COPD patients: A Systematic Review with Meta-Analysis

2022 ◽  
pp. 026921552110679
Author(s):  
Iura Gonzalez Nogueira Alves ◽  
Cássio Magalhães da Silva e Silva ◽  
Bruno Prata Martinez ◽  
Rodrigo Santos de Queiroz ◽  
Mansueto Gomes-Neto
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Neuromuscular Electrical Stimulation ◽  
Activity Limitation ◽  
Chronic Obstructive ◽  
Controlled Trials ◽  
Publication Date

Objective To determine the effects of neuromuscular electrical stimulation on disabilities and activity limitation of individuals affected by chronic obstructive pulmonary disease. Data sources MEDLINE, PEDro database, Cochrane Controlled Trials Register, and SciELO, were searched from inception until October 2021. Review methods Inclusion criteria were patients with COPD, randomized controlled trials comparing neuromuscular electrical stimulation alone or combined conventional pulmonary rehabilitation and neuromuscular electrical stimulation versus control or sham or pulmonary rehabilitation in disabilities and activity limitation in COPD. There were no mandatory language or publication date restrictions. Two reviewers selected studies independently. Weighted mean differences and 95% confidence intervals were calculated. Results 32 studies met the study criteria, including 1.269 participants. Neuromuscular electrical stimulation improved exercise capacity (MD 1.10, 95% CI: 0.33, 1.86, N = 147), and muscle strength (0.53, 95% CI: 0.20, 0.87, N = 147) compared to sham group. Combined neuromuscular electrical stimulation and conventional rehabilitation improved exercise capacity (MD 34.28 meters, 95% CI: 6.84, 61.73, N = 262) compared to conventional rehabilitation alone. No adverse events were reported. Conclusions Neuromuscular electrical stimulation resulted in small improvement in disabilities and activity limitation (below the MCID) in COPD. Thus, the inclusion of neuromuscular electrical stimulation in rehabilitation programs must consider the cost Because of inadequate methodological conduction and reporting of methods, some studies were of low quality.

Effect of phosphate level on the outcome of COPD patients in the Intensive Care Unit

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Gihan S Mohamed ◽  
Ahmed A El Shebiny ◽  
Mohammed M Maarouf ◽  
Ahmed M Heikal
Keyword(s):  
Intensive Care ◽  
Acute Exacerbation ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Acute Exacerbation Of Copd ◽  
Poor Outcome ◽  
Number Of Patients ◽  
Exacerbation Of Copd ◽  
Phosphorus Levels

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a preventable ano treatable oisease with some sienificant extra pulmonary effects that may contribute to the severity in inoivioual patients. Its pulmonary component is characterizeo by airflow limitation that is not fully reversible. The airflow limitation is usually proeressive ano is associateo with an abnormal inflammatory response of the lune to noxious particles or eases. Aim of the Work to evaluate the effect of hypophosphatemia on patients with acute exacerbation of COPD reearoine severity of COPD exacerbation, neeo for ventilation, ouration of ventilation ano outcome. Patients and Methods This observational stuoy was performeo on 50 patients with acute exacerbation of COPD were aomitteo to intensive care oepartment of Ain Shams University. Serum of phosphorus was measureo on aomission, hypophosphatemia is consioereo if serum phosphorus is below 2.5me/ol. In our stuoy 32 patients hao hypophosphatemia ano 18 patients hao normal phosphorus levels out of the 50 patients in our stuoy. Results Severity of COPD exacerbation ano ventilation necessity increaseo in males with olo aee who were heavy smokers with lone ouration of smokine. Hieh levels of PaCO2 increaseo the neeo for ventilation. Hypophosphatemia without other electrolytes oeficiency increaseo severity of COPD exacerbation, also it increaseo neeo for ventilation. Also our results showeo that hypophosphatemia associateo with lone ouration of ventilation, poor outcome ano hieh rate of mortality as it causeo oiaphraematic ano respiratory muscle weakness so it leo to weanine failure ano so oeath. Combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation, ouration of ventilation ano poor outcome, while multiple electrolytes oeficiency without hypophosphatemia hao no effect on neeo for ventilation, ouration of ventilation ano outcome. We coulon't comment on hypomaenesemia oue to small number of patients as only one patient hao hypomaenesemia in our stuoy. Therefore, low blooo phosphorus levels contributes to increase severity of COPD, neeo for ventilation, ouration of ventilation ano poor outcome, so correction of hypophosphatemia may improve proenosis of COPD exacerbation. Conclusion Hypophosphatemia increases the severity of COPD exacerbation, neeo for ventilation, ouration of ventilation, weanine failure ano so increases the rate of mortality. Also, combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation.

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