The new normal? Novel and remote strategies for pulmonary rehabilitation最新文献

{"title":"S25 Cardiopulmonary exercise testing to evaluate exercise limitation and shortness of breath in long COVID","authors":"L. Godinho, A. Freeman","doi":"10.1136/thorax-2021-btsabstracts.31","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.31","url":null,"abstract":"S25 Table 1Preliminary CPET data for patients with persistent symptoms following non-hospitalised SARS-CoV2 infection, demonstrating reduced levels of aerobic fitness compared to% predicted, as assessed by oxygen uptake at peak exercise, oxygen uptake at anaerobic threshold (AT) and O2 pulse.Patient number Peak oxygen uptake as% predicted Peak AT as% of peak oxygen uptake O2 pulse as% predicted VEVCO2 slope Breathing reserve (litres/minute) 1 110 69 101 26.9 59 2 70 31 76 22.6 138 3 91 45 80 31.4 36 4 108 63 93 28.1 84 5 81 46 78 27.7 31 6 81 44 82 26.4 71 7 111 47 106 25.4 69 8 61 33 70 27.5 96 9 64 43 78 29.6 40 ConclusionsCPET provided an objective measure of functional limitation in our preliminary patient cohort, profound deconditioning was apparent. Given that our patient has normal cardiac function, it is possible that the reduction in O2 pulse reflects an intrinsic impairment in muscle oxygen utilisation. We have demonstrated similar patterns of exercise limitation in cancer patients undergoing chemotherapy, and subsequent improvements in their exercise training capacity following a 12 week personalised exercise training program.1 Exercise intervention studies are needed in these patients to determine optimal rehabilitation strategies.ReferenceWest, et al. Br J Anaesth. 2015;114(2):244–5.","PeriodicalId":430324,"journal":{"name":"The new normal? Novel and remote strategies for pulmonary rehabilitation","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125594386","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":"S20 Combining physical activity behavioural modification strategies alongside cognitive behavioural therapy during pulmonary rehabilitation in patients with COPD: An interim analysis of a pilot RCT","authors":"M. Armstrong, E. Hume, L. Mcneillie, F. Chambers, L. Wakenshaw, G. Burns, K. Heslop-Marshall, I. Vogiatzis","doi":"10.1136/thorax-2021-btsabstracts.26","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.26","url":null,"abstract":"S20 Table 1","PeriodicalId":430324,"journal":{"name":"The new normal? Novel and remote strategies for pulmonary rehabilitation","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122428266","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":"S23 Integrating home-based exercise training within a hospital at home service for patients hospitalised with acute exacerbations of COPD: a mixed methods feasibility study","authors":"R. Barker, LJ Brighton, J. Bayly, J. Walsh, C. Nolan, S. Patel, O. Polgar, J. Wenneberg, S. Kon, J. Wedzicha, M. Maddocks, M. Farquhar, W. Man","doi":"10.1136/thorax-2021-btsabstracts.29","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.29","url":null,"abstract":"BackgroundThe uptake of face-to-face supervised outpatient-based pulmonary rehabilitation (PR) following hospitalisation for an acute exacerbation of COPD (AECOPD) is low. One commonly cited barrier is travel. Home-based PR may be an alternative setting. The aim of this study was to determine whether a co-designed home-based exercise training intervention, delivered alongside usual hospital at home (HaH) care post-hospitalisation for an AECOPD, is acceptable and feasible.MethodsA mixed method feasibility study was conducted including a parallel, two-group randomised controlled trial (RCT) (control group: usual HaH care;intervention group: usual care plus home-based exercise training) with convergent qualitative components (interviews: patients, family carers, researchers;focus groups: healthcare professionals [HCPs]).Results16/132 patients screened were recruited to the RCT with 8 allocated to each group and one withdrawn prior to receiving HaH care (56% were male, mean [SD] age: 74 [9] years, median [IQR] FEV1: 29 [21, 40] percent predicted, 87% with an eMRC dyspnoea score of 4, 5a or 5b). Four vs eight and four vs seven attended four week and three-month follow-up assessments in the control and intervention groups respectively. There was no evidence of contamination in the control group. 25% of patients allocated to the intervention group were unable to receive the intervention due to Covid-19. The questionnaire-based outcomes were more complete and appeared more acceptable to patients than physical measures, with very poor uptake for physical activity monitoring via accelerometery. Qualitative findings (interviews: five patients, two family carers, four researchers;focus groups: PR and HaH service HCPs) demonstrated that trial and intervention processes were acceptable, clinically beneficial and safe, but did not explain the disparity between questionnaire-based vs physical outcome measure completion rates.ConclusionThe findings suggest an efficacy trial which investigates home-based exercise training integrated within a HaH service following hospitalisation for an AECOPD would be safe and acceptable to patients, family carers, HCPs and researchers alike, and is qualitatively felt to be of clinical benefit. However, additional piloting is required to optimise intervention fidelity and study processes given the low recruitment rates, high drop out of the control group and poor uptake of some physical assessments.","PeriodicalId":430324,"journal":{"name":"The new normal? Novel and remote strategies for pulmonary rehabilitation","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126808529","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":"S24 Is a novel digital breathing & energy management programme effective in reducing symptoms of long COVID?","authors":"J. Moore, J. Plumbe, N. Hilliard, K. Plumbe, N. Beckett, T. Burch, K. Bahadur","doi":"10.1136/thorax-2021-btsabstracts.30","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.30","url":null,"abstract":"IntroductionThe most common symptoms of ‘Long COVID’ which is defined as symptoms >12 weeks post COVID infection, are breathlessness and fatigue. Breathing retraining and holistic management for patients suffering with ongoing symptoms of COVID has been recommended to help manage these symptoms.1 Ensuring quality rest and activity energy management is essential for the management of chronic fatigue.1,2 The aim of this study is to investigate the effectiveness of a novel digital 6-week breathing & energy group management programme for patients with Long COVID.MethodWe conducted a pilot, cohort, observational study using qualitative questionnaires pre and post intervention between Jan -May 2021. The intervention was led by breathing, fatigue specialist physiotherapists and psychological well-being practitioners. Baseline information was gathered with an individual digital assessment. Participants were enrolled to weekly digital group sessions focusing on breathing retraining and establishing a good energy management balance. A follow up re-assessment was completed post intervention.Results72 participants aged between 24–81, 45 female,27 male, 57 White British, 7 Black British, 2 Black Asian, 6 Other Ethnicity were enrolled. Baseline data showed 87% (n=63) had a breathing pattern disorder (Breathing Pattern Assessment Tool Score> 4.) 69% (n=50) had signs of hyperventilation syndrome (Nijmegen score > 23). 77% were suffering with severe fatigue (Fatigue Severity Scale (FSS) > 5). Outcome measures used were the Self-Reported Chronic Respiratory Disease Questionnaire (SR -CRDQ), General Anxiety Disorder 7 (GAD7), Patient Health Questionnaire PHQ9 and FSS. 86% (n=62) patients had a clinically significant improvement in at least 1 of the SR-CRDQ domains (breathlessness, emotion, fatigue and mastery).53% (n=38) had a clinically significant reduction in FSS. 51% (n=37) patients had a clinically significant improvement in anxiety or depression.ConclusionAnalysis shows that a digital, novel 6 week breathing and energy management programme was beneficial for patients suffering Long COVID. Continued investigation and further research is required to evaluate the effectiveness of breathing retraining and energy management for patients suffering with Long COVID.ReferencesGeorge PM, et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax 2020.Updated NICE guidance on chronic fatigue syndrome. BMJ 2020.","PeriodicalId":430324,"journal":{"name":"The new normal? Novel and remote strategies for pulmonary rehabilitation","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125189596","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":"S21 Feasibility of smartphone-based physical activity tele-coaching in lung transplant recipients","authors":"E. Hume, H. Muse, K. Wallace, M. Wilkinson, K. Heslop-Marshall, A. Nair, J. Sánchez, J. Benavent, J. Roldan, S. Clark, I. Vogiatzis","doi":"10.1136/thorax-2021-btsabstracts.27","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.27","url":null,"abstract":"S21 Figure 1Daily steps using accelerometry (Actigraph GTX3), at baseline (hospital discharge), 3 months and 6 months for lung transplant recipients assigned to the intervention group (n=5)[Figure omitted. See PDF]ConclusionTele-coaching appears feasible in lung transplant recipients, with patients wearing the pedometer and interacting well with the app over 3 months. This is promising in the current climate, with the need to develop and evaluate innovative ways of supporting patients remotely.","PeriodicalId":430324,"journal":{"name":"The new normal? Novel and remote strategies for pulmonary rehabilitation","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131336395","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}