IMU-based monitoring of discharged patients with COVID-19 for the assessment of in-home recovering

No abstract available.publishe

Nonspecific Low Back Pain in association with Chronic Obstructive Pulmonary Disease. A Descriptive Observational Cross-Sectional Study

Introducción. El dolor lumbar inespecífico (DLI) es una condición médica muy prevalente, un 84% de la población general lo ha sufrido a lo largo de su vida. La prevalencia de DLI destaca en individuos con alteración respiratoria, en particular en sujetos con enfermedad pulmonar obstructiva crónica (EPOC). Dentro de las teorías que correlacionan las dos entidades clínicas (como la teoría inflamatoria y su asociación al tabaquismo), impresiona la teoría de control postural. El diafragma, principal músculo de la respiración, a parte de su función inspiratoria, estabiliza el tronco a nivel lumbar. El DLI se relaciona con falta de control postural a nivel de tronco. La EPOC, dentro de su sintomatología, incluye diafragma ineficaz (deformación, debilidad y fatigabilidad), lo que puede correlacionarse a DLI. Hipótesis y objetivos. La hipótesis de partida es que, en sujetos con EPOC, el DLI es resultado de la enfermedad respiratoria. La EPOC puede contribuir, correlacionarse o incluso predisponer a él. El DLI se asociaría a mayor debilidad del diafragma, gravedad de función respiratoria, severidad EPOC y menor nivel de actividad física y calidad de vida en EPOC. Metodología. Se propuso un estudio descriptivo transversal observacional con dos grupos, uno compuesto por 67 sujetos, diagnosticados de EPOC, y otro por 67 sujetos sin enfermedad pulmonar. Se recogieron datos a cerca de: función pulmonar, mediante espirometría; fuerza de los músculos respiratorios, mediante medición de presiones inspiratoria y espiratoria máximas (PIM, PEM); control postural de tronco, mediante pruebas de control motor (KLAT, ASLR); calidad de vida en EPOC, mediante el COPD Assessment Test (CAT); nivel de actividad física, mediante el Cuestionario de Actividad Física de Baecke modificado (MBPAQ); localización del dolor, mediante mapa corporal; intensidad del dolor, mediante Escala Visual Analógica (EVA); discapacidad relacionada a dolor lumbar, mediante Índice de discapacidad de Oswestry (ODI). Para el primer grupo, se reclutaron sujetos diagnosticados de EPOC en contexto de consulta hospitalaria de neumología y, para el segundo, sujetos sin enfermedad pulmonar captados dentro y fuera el contexto hospitalario. Se procedió a la recogida de datos de una valoración, en una única sesión, incluyendo pruebas para función pulmonar, fuerza de los músculos respiratorios, control postural de tronco y escalas y cuestionarios para calidad de vida, nivel de actividad física, dolor y discapacidad. Resultados. La muestra final constó de 39 sujetos (n = 20, casos con EPOC; n = 19, controles sin enfermedad pulmonar). En el análisis de correlación de presiones respiratorias con las variables de control postural de tronco, el nivel de actividad física y la intensidad del DLI no se encuentra una relación lineal positiva (p > 0,05) ni en sujetos con EPOC, ni en sujetos sin enfermedad pulmonar. Sólo en mujeres con EPOC, la intensidad del dolor presenta correlaciones estadísticamente significativas con las presiones respiratorias, positiva con la PIM (p = 0,01, cc. = 1,00) y negativa con la PEM (p = 0,01, cc = -1,00). No se detecta relación entre la presencia de dolor actual o en el último año y el nivel de actividad física (p > 0,05) en ambos grupos. El nivel de severidad de la EPOC y el control motor no muestran correlación positiva (p > 0,05). Mientras, el impacto sobre la calidad de vida de la EPOC y el nivel de discapacidad procedente del DLI presentan relación lineal positiva (p = 0,012, cc. = 0,953). En el análisis de contraste entre los dos grupos: - no hay homogeneidad en cuanto al sexo (p = 0,006), contrariamente a la edad y el IMC (p > 0,05); - no se encuentran diferencias estadísticamente significativas respecto a la presencia de DLI, bien actual bien durante el último año (p = 0,239 y p = 0,433, respectivamente); - se aprecian diferencias estadísticamente significativas respecto a: las presiones respiratorias en hombres (en la PIM, p = 0,003; en la PEM, p = 0,045); las pruebas de control motor (en la KLAT, p = 0,037; en la ASLR, p = 0,016), en particular en hombres (en la KLAT, p = 0,006; en la ASLR, p = 0,036); el nivel de actividad física MBPAQ (p = 0,048). Conclusiones. Los resultados preliminares no han mostrado una correlación positiva entre EPOC y DLI, aunque las tendencias sugieren que, con el tamaño muestral completo, se podrían encontrar. No se ha podido establecer una relación entre la gravedad de la función pulmonar en EPOC y el control postural de tronco, aunque, cualitativamente, a mayor severidad corresponde mayor inestabilidad. La calidad de vida en EPOC se relaciona directamente con el nivel de discapacidad causado por el DLI. No se encuentra asociación significativa entre la fuerza de la musculatura respiratoria y el control postural de tronco en ambos grupos. La presencia de DLI actual o recurrente en el último año no se relaciona, con significación estadística, con el nivel de actividad física en ambos grupos. Existen diferencias estadísticamente significativas entre los dos grupos en la fuerza de los músculos respiratorios en hombres, el control postural en ambos sexos (más en hombres) y el nivel de actividad física.Introduction/Background. Nonspecific low back pain (NSLBP) is a very prevalent medical condition (84% of the general population has suffered from it throughout its lifetime). Its prevalence stands out in individuals with respiratory disease, especially in subjects with chronic obstructive pulmonary disease (COPD). Even if there are many theories that create a relationship between the two clinical conditions (such as inflammation associated with smoking), the postural control one is quite impressive. The diaphragm is the main muscle of breathing with its inspiratory function, but it takes part in trunk stabilization on lumbar spine. NSLBP is related to lack of spinal control. The COPD symptoms include lack of efficiency in diaphragm (deformation, weakness and fatigability), which could be connected to NSLBP. Hypothesis and objectives. The starting hypothesis is that NSLBP is a result of an associated pulmonary disease. COPD can contribute, correlate or even predispose them. NSLBP is associated with diaphragm weakness, severity of respiratory function, COPD severity, lower level of physical activity and quality of life in COPD. Methods. A descriptive observational cross-sectional study was conducted with two groups: the first one with 67 subjects, diagnosed with COPD, and the second one with 67 subjects without pulmonary disease. Data were collected on: pulmonary function, spirometry; respiratory muscles strength by measuring maximal inspiratory and expiratory pressures (MIP, MEP); trunk postural control by motor control tests (KLAT, ASLR); quality of life with COPD, through the COPD Assessment Test (CAT); physical activity level, using the Modified Baecke Physical Activity Questionnaire (MBPAQ); pain localization, through a body map; pain intensity, using Visual Analogue Scale (VAS) and disability, related to lumbar pain (if there is one), using the Oswestry Disability Index (ODI). The first group, with subjects diagnosed with COPD, was recruited in the hospital context, while the second one, with subjects without lung disease, was recruited in and out of the hospital context. Data were collected in a single session through tests for pulmonary function, respiratory muscle strength and trunk postural control. They were also collected using scales and questionnaires that measure the quality of life, physical activity level, pain and disability. Results. The final sample consisted of 39 subjects (n = 20, cases with COPD, n = 19, controls without lung disease). The statistical analysis between respiratory pressures individually with postural control, physical activity level and NSLBP intensity doesn´t show a positive linear relationship (p> 0.05) either in subjects with COPD or in subjects without lung disease. Only in women with COPD, the intensity of pain has statistically significant correlation with respiratory pressures: a positive one with MIP (p = 0.01, cc = 1.00) and a negative one with MEP (p = 0.01, cc = -1.00). There’s no association between the presence of current or last year NSLBP and the physical activity level (p> 0.05) in both groups. The stages of COPD and motor control do not have a positive correlation (p> 0.05). Meanwhile, a positive linear relationship is evidenced between the quality of life in COPD and the disability level caused by NSLBP (p = 0.012, cc = 0.953). An estimation of differences between the two groups shows that: - there’s non-homogeneity of sex (p = 0.006), but homogeneity of age and BMI (p> 0.05); - no statistically significant differences have been found regarding the presence of current or last year NSLBP (p = 0.239 and p = 0.433, respectively); - statistically significant differences have been observed in respiratory pressures in men (in the MIP, p = 0.003, in the MEP, p = 0.045), motor control tests (in KLAT, p = 0.037, in ASLR, p = 0.016), particularly in men (in KLAT, p = 0.006, in ASLR, p = 0.036), and physical activity level in MBPAQ (p = 0.048). Conclusions. Preliminary results don´t show a correlation between COPD and NSLBP, although trends imply that, with a full sample size, it would be a positive one. It is not possible to establish a relationship between the severity of lung function in COPD and trunk postural control, although data show that more advanced staged COPD corresponds to greater instability. Quality of life in COPD is directly related to the disability level caused by NSLBP. No significant association has been found between respiratory muscles strength and trunk postural control in both groups. There is no statistical significance between the presence of current or last year NSLBP and the physical activity level in both groups. There are statistically significant differences between the two groups in respiratory muscles strength in men, postural control in both genders (more in men) and physical activity level.Grado en Fisioterapi

Validation of "CENTR(AR)" walking trails: different field criteria do not lead to different physical activity intensities in people with COPD

Background Validating walking trails is essential to promote physical activity (PA) safely and confidently in people with COPD. Objectives We aimed to validate predetermined light, moderate, and vigorous intensities of walking trails in people with COPD. Methods This cross-sectional study included individuals with COPD walking in predetermined light, moderate and vigorous intensity trails. Activity intensity and volume outcomes were collected. Dyspnoea and fatigue (modified Borg scale), energy expenditure (EE, Sensewear), heart rate (HR, HR monitor), time spent in different PA intensities, and cadence (ActiGraph) were recorded and used to classify PA intensity. Results Twenty people with COPD [71(7) years, 80 % male, FEV1%predicted 65.6(11.6)] were included. Fatigue differed significantly between light and moderate [3.0(2.0;4.0) vs 3.4(2.5;4.5), p = 0.01], but not vigorous (3.5[2.5–4.0]) tracks. Dyspnoea [2.3(1.5) vs 2.7(1.6) vs 2.6(1.4)], EE [5.1(0.8) vs 4.9(0.5) vs 4.6(0.8) METs], HR [92.5(11.1) vs 93.7(18.6) vs 95.4(15.0) beats/min] and cadence [115.1(104.0;120.3) vs 104.7(99.6;117.6) vs 111.2(99.9;118.5) steps/min] were similar across trails (p > 0.05). Time spent in light and moderate PA, EE volume, walking time, and step count increased along with the proposed intensity levels (p < 0.01). Walking trails were categorised as moderate intensity in most participants. Conclusion Walking trails were safe and valid for practising moderate-intensity PA in people with COPD. Participants adjusted their physiological responses and perceived symptoms to match a moderate intensity.publishe

Efficacy of Exercise on Postneedling Soreness: A Randomized Controlled Trial

This study aimed to investigate the efficacy of concentric, eccentric, and isometric exercise protocols on the postneedling soreness (PNS) after the dry needling (DN) of latent myofascial trigger points (MTrP) in the medial gastrocnemius muscle. A randomized clinical trial was carried out. Volunteers, &ge;18 years old, with a latent MTrP in the medial gastrocnemius muscle were included. Subjects with contraindications to DN, active MTrPs, and/or other treatments in MTrPs in the 3 months prior to recruitment were excluded. A total of 69 participants were randomly allocated to four groups, where post-DN intervention consisted of an eccentric, concentric, or isometric exercise, or no exercise, and they were assessed for PNS intensity (visual analog scale (pVAS)), pressure pain threshold (PPT, analog algometer), pain intensity (nVAS), and local twitch responses (LTRs) during DN, as well as demographics and anthropometrics. The mixed-model analyses of variance showed significant interaction between time and pVAS, and between time and PPT (p &lt; 0.001). While the multivariate test confirmed that PNS and PPT improved over time within each group, specifically between 6&ndash;12 h post-intervention, the post hoc analyses did not show significant differences between groups. The mixed-model analyses of covariance showed a significant nVAS effect (p &lt; 0.01) on PNS decrease, and some effect of the LTRs (p &lt; 0.01) and sex (p = 0.08) on PPT changes. All groups improved PNS and PPT, but none of them showed a greater improvement above the others. The most dramatic decrease was observed between 6&ndash;12 h post-exercise, although concentric and eccentric exercise had an effect immediately after the intervention. Between all potential modifiers, pain during DN significantly influenced PNS progression, while LTRs and sex seemed to determine PPT course over time

ERS International Congress 2023: Highlights from the Allied Respiratory Professionals assembly

This manuscript has recently been accepted for publication in the ERJ Open Research (Accepted November 15, 2023). It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. https://openres.ersjournals.com/content/early/2023/11/16/23120541.00889-2023Accepted Version: Not Permitted - This policy does not allow for Open Access for this version.This paper summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society (ERS) International Congress. Two sessions from each Assembly group are outlined in the present paper, covering the following topics: Group 9.1 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.2 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.3 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.4 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights paper provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.info:eu-repo/semantics/publishedVersio