A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022最新文献

{"title":"Influence of Adherence to an App-Based Pulmonary Rehabilitation Maintenance Program on Physical Activity and Quality of Life in COPD Patients - a Subgroup Analysis of a Randomized Controlled Trial","authors":"R. Gloeckl, M. Spielmanns, I. Jarosch, D. Leitl, T. Schneeberger, T. Boeselt, S. Huber, P. Kaur-Bollinger, B. Ulm, C. Mueller, Jonas Bjoerklund, S. Spielmanns, W. Windisch, A. Koczulla","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1030","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1030","url":null,"abstract":"","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116216215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Home-Based Respiratory Physiotherapy and Telephone-Based Psychological Support on Pulmonary and Mental Health Outcomes in Peru: A Feasibility Randomized Controlled Trial","authors":"A. N. Soriano, A. H. Coico-Lama, E. Flores, J. Gálvez-Buccollini, G. Gianella, S. Hartinger, A. Lescano, W. Checkley, WAYRA working group","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1029","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1029","url":null,"abstract":"Introduction: We sought to determine whether a 6-week integrated rehabilitation program improved pulmonary function, physical and mental health outcomes in patients discharged alive after surviving a severe COVID-19 pneumonia. Methods: Parallel, open-label, feasibility randomized controlled trial in participants aged 18-75 years who were discharged for severe COVID-19 pneumonia. The intervention consisted of 12 in-person home respiratory rehabilitation sessions and 6 telephonebased, emotion-centered problem-solving therapy psychological sessions. We measured the 6- minute walk test (6MWT), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), Patient Health Questionnaire (PHQ-9), General Anxiety Disorder (GAD-7), Impact of Event Scale- Revised (IES-R) and Short Form 36 health survey (SF-36). Following the recommendation by Cocks and Torgerson, we used a one-sided 80% confidence interval to determine if this feasibility trial should proceed to a phase III trial. Results: We randomized 103 participants (mean age, 48 years;71% men). There were no differences at baseline assessments of outcomes between the two groups. Intervention participants walked 15 and 45 meters more during a 6MWT at 7 and 12 weeks, respectively, than controls after accounting for baseline distance. In both instances, the onesided 80% lower bound was above 0. Intervention participants also had a greater improvement of lung function for week 7 (mean difference FEV1, 0.05 L;95% CI, -0.14 to 0.24;mean difference FVC, 0.10 L;95% CI, -0.12 to 0.31) and at week 12 (mean difference FEV1, 0.10 L;95% CI, -0.18 to 0.37;mean difference FVC, 0.15 L;95% CI, -0.17 to 0.47). Likewise, the prevalence of depression (percentage difference PHQ-9, 24.3%;95% CI, -4.3 to 44.3), anxiety (percentage difference GAD-7, 20.7%;95% CI, 0.8 to 40.6) and post-traumatic stress (percentage difference IES-R, 14.0%;95% CI, -5.7 to 33.7) were lower in the intervention group at week 2 after hospital discharge. At week 7, the intervention group had a greater improvement of physical (mean difference, 10.8;95% CI, -1.8 to 23.4) and social (mean difference, 6.43;95% CI, -0.65 to 13.5) function on the SF-36. Conclusion: We demonstrated that an integrated rehabilitation program administered over a 6-week after discharge in Lima, Peru was both feasible and acceptable, and had positive benefits on physical and pulmonary function and on mental health during the 12 weeks of follow-up. Measured improvements in the primary outcome of 6MWT distance recommend that we consider a phase III trial to test the efficacy of our integrated rehabilitation intervention in a larger sample.","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127376214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of High-Intensity Interval Training on Inhaled Corticosteroid Dose in Patients with Asthma - a Randomized Controlled Trial","authors":"A. Pitzner-Fabricius, C. Dall, M. Henriksen, E. Hansen, L. Toennesen, M. Hostrup, N.V. Backer","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1026","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1026","url":null,"abstract":"","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122641455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Many Monitoring Days Are Necessary to Assess the Sedentary Behavior of Individuals with COPD?","authors":"F. Pitta, M. P. Pereira, R. Hirata, L. Sartori, L. Schneider, I. Brito, N. Hernandes, K. C. Furlanetto","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1033","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1033","url":null,"abstract":"","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130559214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Home-Based Rehabilitation with Health Coaching on Chronic Obstructive Pulmonary Disease Outcomes: A Randomized Study","authors":"R. Benzo, J. Hoult, C. McEvoy, M. Clark, M. Benzo, M.M. Johnson, P. Novotny","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1027","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1027","url":null,"abstract":"Importance Pulmonary rehabilitation (PR) is the guideline-recommended most effective nonpharmacological therapy for people with chronic obstructive pulmonary disease (COPD) improving all outcomes. Despite the proven benefits, PR programs have low participant uptake, insufficient attendance, and high drop-out rates. Home programs are proposed as a solution: however, there is no randomized study to date in the US to inform remote programs.Objective To determine whether unsupervised home-based rehabilitation with technology and health coaching improve physical and emotional disease specific quality of life, daily physical activity, and self-management in patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD).Design, Setting, and Participants This multicenter, randomized, allocation-concealed, clinical trial enrolled 235 adult patients with COPD, of a planned sample size of 200, between March 2018 and December 2021 from two major health care systems in the US.Interventions Participants were randomized to unsupervised home-based rehabilitation with health coaching (N=116) or standard care (n = 119).Main Outcomes and Measures The primary outcome were disease-specific physical and emotional quality of life after the 12-week intervention. Prespecified secondary outcomes included measured daily physical activity, selfmanagement abilities, sleep, and symptoms of depression and anxiety.Results Among 307 patients who were randomized (mean age, 69 years;56% women) 235 (77%) completed the intervention and had measures. The was a significant difference in the intervention compared to the control group in the primary outcomes, daily physical activity, self-management, sleep, and depression scores: (adjusted Difference, Mean Change (95% CI) 0.47 points (0.27, 0.67) p<0.001, 0.48 (0.27, 0.69)p<0.001 for the physical and emotional quality of life respectively. Daily steps 655.83 (148.03, 1163.64) p<0.0116, selfmanagement 3.83 (1.85, 5.79) p<0.001, depression PHQ-9 -1.2 (-2.04, -0.35) p<0.0056 and total sleep time 54 min (6.74, 102.96) p<0.025 .Conclusions and Relevance Among patients with moderate to severe COPD, unsupervised home-based rehabilitation with monitoring technology and health coaching improved quality of life, daily physical activity, and self-management. This intervention represents an opportunity to increase the uptake of rehabilitation in COPD and to inform options of remote care that are now in increased demand in the context of the COVID-19 pandemic. (Figure Presented).","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115240565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Structured Diagnostic Approach for Breathlessness on Patient Related Outcome Measures; Six-Month Results from a Feasibility Multi-Centre Cluster Randomised Control Trial in Primary Care","authors":"G. Doe, J. Clanchy, S. Wathall, S. Barber, S. Edwards, H. Evans, N. Baxter, D. Jackson, M. Steiner, R. Evans","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1034","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1034","url":null,"abstract":"","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115232049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired Spirometry and Older Age Predict Skeletal Muscle Oxidative Capacity in COPD","authors":"A. Adami, F. Duan, R. Calmelat, Z. Chen, R. Casaburi, H. Rossiter","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1031","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1031","url":null,"abstract":"","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124454479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oscillatory Positive Expiratory Pressure (OPEP) Therapy in Chronic Obstructive Pulmonary Disease (COPD): The O-COPD Trial","authors":"S. Alghamdi, A. AlAsmari, A.S. Alsulayyim, K. E. Philip, S. Buttery, P. Williams, C. Orton, S. Birring, M. Polkey, N. Hopkinson","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1028","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1028","url":null,"abstract":"","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129822907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description and Reliability of Internet Resources on Pulmonary Rehabilitation for Individuals with Chronic Lung Disease","authors":"T. Da Silva, Aziz Lokhandwala, N. Al Kaabi, J. Semenchuk, G. Goobie, E. Camacho, W. Reid, J. Fisher, C. Ryerson, D. Rozenberg","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1032","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1032","url":null,"abstract":"RATIONALE Pulmonary rehabilitation (PR) is an important management modality in individuals with chronic lung disease. The internet is commonly used as a source of health information by individuals with lung disease. Given the ongoing COVID-19 pandemic and closure of in-person PR programs, many patients with lung disease rely on online resources for exercise training;however, the quality and reliability of online information on PR has not been evaluated. Thus, the objective of this study is to characterize internet resources on PR, and to assess the readability, content and quality of patient-directed PR resources. METHODS The first 200 websites for the search term 'pulmonary rehabilitation resources and exercise' were analyzed in Google, Yahoo and Bing. Website content was evaluated based on a predefined scoring system of the key components of PR, as described in the most recent international consensus guidelines. Website quality and reliability were determined using the validated DISCERN instrument and the Global Quality Scale (GQS). RESULTS A total of 70 unique websites were identified with the two most common categories being academic resources (63%) and foundation/advocacy organizations (33%). The average reading grade level of PR websites was equivalent to grade 11. There was significant heterogeneity in content (Table 1) across websites related to exercise training, education, and behaviour change (17.7 ± 5.1 out of 30). Most websites focused on traditional modalities of aerobic (96%) and resistance training (87%), in contrast to balance exercises (16%) and inspiratory muscle training (19%). A small majority of websites provided education focused on smoking cessation (59%), breathing strategies (59%), and nutrition (54%), with fewer websites addressing self-efficacy (37%) and motivation (13%). Website quality was good across PR websites (DISCERN median score 4.0 IQR (3.0-4.0) and GQS 4.0 IQR (2.0-4.0) out of 5 for both measures). CONCLUSIONS PR content varied significantly across websites and only partially captured items outlined in the PR international consensus guidelines. Website quality was good, suggesting that most PR websites were overall useful for patients;however, the higher-than-recommended reading level of patient education materials may compromise utilization and comprehension of PR resources. Efforts need to be made to better tailor online PR resources to the general lung population. (Figure Presented).","PeriodicalId":217064,"journal":{"name":"A16. PULMONARY REHABILITATION: TRANSFORMING OUR PRACTICE IN 2022","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128755317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}