Avaliação dos efeitos do treinamento do exercício físico aeróbico de curta duração em pacientes hospitalizados com DPOC exacerbado

Introduction: Acute Exacerbation (AE) is an important cause of impairment of function in chronic obstructive pulmonary disease (COPD) patients. Negatively affects the quality of life, lung function, muscle weakness, the use of health resources and survival. However, physical exercise performed during the exacerbation can improve the quality of life and the physical capacity of the patient. In this context, this study aims to evaluate the influence of aerobic exercise in hospitalized COPD patients with exacerbation (AECOPD). Objective: To evaluate the effects of short duration aerobic exercise in AECOPD on dyspnea score, quality of life and exercise capacity. Patients and Methods: Twenty-two patients were randomized in two groups; the control group received standard medical treatment and the intervention group that performed aerobic exercise training. All patients performed spirometry, nutritional assessment, distance covered on the six-minute walk test (6MWD), quality of life (Saint George Respiratory Questionnaire- SGRQ), anxiety and depression ( The Hospital Anxiety and Depression Scale), BODE index and intensity of dyspnea (Baseline Dyspnea Index and Modified Medical Research Council Score) after 48 hours of hospitalization and after one month of discharge. The exercise program consisted of aerobic training on a treadmill twice a day for 15 minutes until to the discharge. Results: The impact domain and the total score of quality of life showed a higher increase in the intervention group compared to the control group (p<0.001) when compared to the moments. Both groups showed improvement in the activity domain of SGRQ after one month of hospital discharge, but they did not show difference between groups. Furthermore, only the intervention group showed significant improvement in the symptom domain of SGRQ (p<0.001) and baseline dyspnea index (p=0.006) after one month. 6MWD and BODE did not show difference between ...Introdução: Exacerbação aguda (EA) é uma importante causa de perda de funções em pacientes que sofrem de doença pulmonar obstrutiva crônica (DPOC). Afeta negativamente a qualidade de vida, a função pulmonar, a fraqueza muscular, a utilização dos recursos da saúde e a sobrevida. Entretanto, o exercício físico realizado durante a exacerbação pode melhorar a qualidade de vida e a capacidade física do paciente. Nesse contexto, o presente estudo visa avaliar a influência da realização do exercício físico em pacientes hospitalizado por exacerbação da DPOC (EADPOC). Objetivo: O presente estudo visa avaliar os efeitos do exercício fisico aeróbio de curta duração nos pacientes hospitalizados por exacerbação aguda de DPOC no escore da dispneia, na qualidade de vida e na capacidade física. Pacientes e Métodos: Vinte e dois pacientes foram randomizados em dois grupos, o grupo controle que recebeu o tratamento clínico padrão e o grupo de intervenção que realizou o treinamento de exercício físico juntamente com os cuidados clínicos. Os pacientes foram submetidos às seguintes avaliações após 48 horas da hospitalização e após um mês da alta: espirometria, avaliação nutricional, distância percorrida no teste de caminhada de seis minutos (DP6), qualidade de vida, ansiedade e depressão, índice de BODE e intensidade de dispneia. O programa de exercício físico foi composto por treinamento aeróbio em esteira ergométrica, duas vezes ao dia, por 15 minutos cada sessão até o período da alta hospitalar. Resultados: O domínio impacto e o escore total da qualidade de vida apresentaram maior incremento no grupo intervenção em relação ao grupo controle (p < 0,001) quando comparado os momentos. Houve melhora de ambos os grupos após um mês de alta hospitalar no domínio atividade quando comparado ao momento basal, mas sem diferença entre os grupos. Além disso, apenas o grupo de intervenção apresentou..

Gate-controlled phase switching in a parametron

ISSN:1539-3755ISSN:1063-651XISSN:1095-3787ISSN:1550-237

Assessment of Aerobic Exercise Adverse Effects during COPD Exacerbation Hospitalization

Introduction. Aerobic exercise performed after hospital discharge for exacerbated COPD patients is already recommended to improve respiratory and skeletal muscle strength, increase tolerance to activity, and reduce the sensation of dyspnea. Previous studies have shown that anaerobic activity can clinically benefit patients hospitalized with exacerbated COPD. However, there is little information on the feasibility and safety of aerobic physical activity performed by patients with exacerbated COPD during hospitalization. Objective. To evaluate the effects of aerobic exercise on vital signs in hospitalized patients with exacerbated COPD. Patients and Methods. Eleven COPD patients (63% female, FEV1: 34.2 ± 13.9% and age: 65 ± 11 years) agreed to participate. Aerobic exercise was initiated 72 hours after admission on a treadmill; speed was obtained from the distance covered in a 6-minute walk test (6MWT). Vital signs were assessed before and after exercise. Results. During the activity systolic blood pressure increased from 125.2 ± 13.6 to 135.8 ± 15.0 mmHg (p=0.004) and respiratory rate from 20.9 ± 4.4 to 24.2 ± 4.5 rpm (p=0.008) and pulse oximetry (SpO2) decreased from 93.8 ± 2.3 to 88.5 ± 5.7% (p<0.001). Aerobic activity was considered intense, heart rate ranged from 99.2 ± 11.5 to 119.1 ± 11.1 bpm at the end of exercise (p=0.092), and patients reached on average 76% of maximum heart rate. Conclusion. Aerobic exercise conducted after 72 hours of hospitalization in patients with exacerbated COPD appears to be safe

Clinical Study Assessment of Aerobic Exercise Adverse Effects during COPD Exacerbation Hospitalization

Introduction. Aerobic exercise performed after hospital discharge for exacerbated COPD patients is already recommended to improve respiratory and skeletal muscle strength, increase tolerance to activity, and reduce the sensation of dyspnea. Previous studies have shown that anaerobic activity can clinically benefit patients hospitalized with exacerbated COPD. However, there is little information on the feasibility and safety of aerobic physical activity performed by patients with exacerbated COPD during hospitalization. Objective. To evaluate the effects of aerobic exercise on vital signs in hospitalized patients with exacerbated COPD. Patients and Methods. Eleven COPD patients (63% female, FEV1: 34.2 ± 13.9% and age: 65 ± 11 years) agreed to participate. Aerobic exercise was initiated 72 hours after admission on a treadmill; speed was obtained from the distance covered in a 6-minute walk test (6MWT). Vital signs were assessed before and after exercise. Results. During the activity systolic blood pressure increased from 125.2 ± 13.6 to 135.8 ± 15.0 mmHg (p = 0.004) and respiratory rate from 20.9 ± 4.4 to 24.2 ± 4.5 rpm (p = 0.008) and pulse oximetry (SpO 2 ) decreased from 93.8 ± 2.3 to 88.5 ± 5.7% (p &lt; 0.001). Aerobic activity was considered intense, heart rate ranged from 99.2 ± 11.5 to 119.1 ± 11.1 bpm at the end of exercise (p = 0.092), and patients reached on average 76% of maximum heart rate. Conclusion. Aerobic exercise conducted after 72 hours of hospitalization in patients with exacerbated COPD appears to be safe

Smoking and Early COPD as Independent Predictors of Body Composition, Exercise Capacity, and Health Status.

The effects of tobacco smoke, mild/moderate COPD disease and their combined effect on health status (HS), body composition (BC), and exercise capacity (EC) impairment are still unclear. We hypothesized that smoking and early COPD have a joint negative influence on these outcomes. We evaluated 32 smokers (smoking history >10 pack/years), 32 mild/moderate COPD (current smokers or former smokers), and 32 never smokers. All individuals underwent medical and smoking status evaluations, pre and post-bronchodilator spirometry, BC [fat-free mass (FFM) and FFM index (FFMI)], EC [six-minute walk distance (6MWD)] and HS [Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)]. FFM (p = 0.02) and FFMI (p = 0.008) were lower in COPD than never smokers. 6MWT, as a percentage of reference values for the Brazilian population, was lower in COPD and smokers than never smokers (p = 0.01). Smokers showed worse SF-36 score for functional capacity than never smokers (p<0.001). SF-36 score for physical functioning (p<0.001) and role-emotional (p<0.001) were impaired in COPD patients than smokers. SF-36 scores for physical functioning (p<0.001), role-physical (p = 0.01), bodily pain (p = 0.01), vitality (p = 0.04) and role-emotional (p<0.001) were lower in COPD than never smokers. Multiple linear regression analysis showed that both COPD diagnosis and smoking were inversely associated with FFMI, 6MWD and HS. Smoking and early COPD have a joint negative influence on body composition, exercise capacity and health status

Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

ABSTRACT Objective: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. Methods: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen. The Saint George’s Respiratory Questionnaire (SGRQ) was used in order to assess quality of life, and the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index was calculated. The frequency of exacerbations and the mortality rate were noted. Treatment nonadherence was defined as LTOT use for < 12 h per day or no LTOT use during exercise. Results: A total of 60 patients with COPD and exertional hypoxemia were included in the study. Of those, 10 died and 11 experienced severe hypoxemia during follow-up, 39 patients therefore being included in the final analysis. Of those, only 18 (46.1%) were adherent to LTOT, showing better SGRQ scores, higher SpO2 values, and lower PaCO2 values than did nonadherent patients. In all patients, SaO2, the six-minute walk distance, and the BODE index worsened after one year. There were no differences between the proportions of adherence to LTOT at 3 and 12 months of follow-up. Conclusions: Quality of life appears to be lower in patients with COPD and exertional hypoxemia who do not adhere to LTOT than in those who do. In addition, LTOT appears to have a beneficial effect on COPD symptoms (as assessed by SGRQ scores). (Brazilian Registry of Clinical Trials - ReBEC; identification number RBR-9b4v63 [http://www.ensaiosclinicos.gov.br]

Percentage values of predicted exercise capacity evaluated by 6MWD p<0.05 (Kruskal-Wallis and Dunn's test).

<p>Percentage values of predicted exercise capacity evaluated by 6MWD p<0.05 (Kruskal-Wallis and Dunn's test).</p

Health Status evaluated by SF-36 of the individuals according studied groups.

<p>Health Status evaluated by SF-36 of the individuals according studied groups.</p

Predictors of body composition (FFMI), exercise capacity (6MWD) and health status (SF-36 physical functioning score).

<p>Predictors of body composition (FFMI), exercise capacity (6MWD) and health status (SF-36 physical functioning score).</p

Predictors of body composition (FFMI), exercise capacity (6MWD) and health status (SF-36 physical functioning score).

<p>Predictors of body composition (FFMI), exercise capacity (6MWD) and health status (SF-36 physical functioning score).</p