Is there any simple tool to enhance physical activity in patients with COPD?

Background: Physical inactivity is considered as a complex behaviour that predicts poor outcomes in COPD and hastens the disease progression. Pulmonary rehabilitation has been endorsed as an effective non-pharmacological therapy to enhance exercise capacity and quality of life in patients with COPD, yet its effects on promotion of physical activity is unknown. Furthermore, the recent international guidelines on pulmonary rehabilitation emphasize on “long-term health enhancing behaviour change” and increase in physical activity is considered to enhance positive health benefits in COPD. The current study had explored the effects of ground walking prescription combined with comprehensive pulmonary rehabilitation to promote physical activity in patients with COPD. Methods: Retrospective analysis were performed on 33 COPD patients [FEV1: 59.08 % (± 22.00)] enrolled to a comprehensive 8 weeks out patients PR programme (PRP). Patients were provided with individualized ground walking prescription and feedback during PRP. Paired t-test was used to examine mean difference between outcomes at Week 0 and Week 8. A p - value < 0.05 was considered significant. Results: 29 patients completed the 8 weeks out-patient PRP. Significant improvements were observed in 6 min walk test (p ˂ 0.0001), incremental shuttle walk test (p ˂ 0.0081), CAT score (p ˂ 0.0017), Chronic Respiratory Disease Questionnaire total score (p ˂ 0.0002) and mMRC dyspnea scale (p ˂ 0.0001) at Week 8 compared to Week 0. Mean walking duration per session and days per week improved from Week 0 to Week 8 (p ˂ 0.0001 and p = 0.0054). Conclusion: This study suggests that inclusion of ground walking prescription would be pragmatic behavioral intervention during comprehensive PR to stimulate physical activity behavior in patients with COPD

Is there any simple tool to enhance physical activity in patients with COPD?

Background: Physical inactivity is considered as a complex behaviour that predicts poor outcomes in COPD and hastens the disease progression. Pulmonary rehabilitation has been endorsed as an effective non-pharmacological therapy to enhance exercise capacity and quality of life in patients with COPD, yet its effects on promotion of physical activity is unknown. Furthermore, the recent international guidelines on pulmonary rehabilitation emphasize on “long-term health enhancing behaviour change” and increase in physical activity is considered to enhance positive health benefits in COPD. The current study had explored the effects of ground walking prescription combined with comprehensive pulmonary rehabilitation to promote physical activity in patients with COPD. Methods: Retrospective analysis were performed on 33 COPD patients [FEV1: 59.08 % (± 22.00)] enrolled to a comprehensive 8 weeks out patients PR programme (PRP). Patients were provided with individualized ground walking prescription and feedback during PRP. Paired t-test was used to examine mean difference between outcomes at Week 0 and Week 8. A p - value < 0.05 was considered significant. Results: 29 patients completed the 8 weeks out-patient PRP. Significant improvements were observed in 6 min walk test (p ˂ 0.0001), incremental shuttle walk test (p ˂ 0.0081), CAT score (p ˂ 0.0017), Chronic Respiratory Disease Questionnaire total score (p ˂ 0.0002) and mMRC dyspnea scale (p ˂ 0.0001) at Week 8 compared to Week 0. Mean walking duration per session and days per week improved from Week 0 to Week 8 (p ˂ 0.0001 and p = 0.0054). Conclusion: This study suggests that inclusion of ground walking prescription would be pragmatic behavioral intervention during comprehensive PR to stimulate physical activity behavior in patients with COPD

Is COVID-19 an invitation to reconfigure or reinvent pulmonary rehabilitation service delivery?

The Outbreak of COVID-19 pandemic demanded a swift reconfiguration of healthcare delivery to mitigate the associated risk and case-fatality. Patients with chronic respiratory disease (CRD) were at higher risk with residual “multiorgan” manifestations of COVID -19. Post-COVID rehabilitation is on high demand to alleviate symptoms and reduce mortality in patients with chronic respiratory disease (CRD). Pulmonary rehabilitation is endorsed as an integrative management, an essential component of respiratory medicine for CRD. However, COVID -19 pandemic has sparked many controversies and challenges on the pulmonary rehabilitation service delivery around the world. This article explores perspectives and action strategies for an agile pulmonary rehabilitation service in the era of COVID-19

Renewed vision on pulmonary rehabilitation service delivery for chronic obstructive pulmonary disease management beyond COVID-19

Pulmonary rehabilitation (PR) is a cornerstone management for chronic obstructive pulmonary disease (COPD). International respiratory societies defined PR is more than “just an exercise program”; it is a comprehensive care delivered by a team of dedicated healthcare professionals with a strong emphasis on long-term health-enhancing Behaviors. However, “Uncertainty” exists with varied reasons for the political and geographical barriers of referral, uptake, attendance, and completion of PR in both primary and secondary care. Besides, COVID-19 pandemic has sparked many global controversies and challenges on pulmonary rehabilitation service delivery. Post-COVID-19 guidelines emphasize on integrated care rehabilitation for patients with COPD. Thus, this concise review intends to understand the gaps in United Kingdom healthcare policies, practices, and PR services resources. To date, there is no clear consensus on PR integrated care model pathway to address the unmet needs, measure the health and social care disparities; adds to the disease burden of COPD. Based on the culmination of evidence, this perspective offers a theoretical framework of PR integrated service model, a pathway to deliver high-value personalized care to patients with COPD

Innovative strategies to optimize the demands on pulmonary rehabilitation

5x7 Black and White Acetate Negativehttps://digitalmaine.com/arc_george_french_photos_a57/1631/thumbnail.jp

Validation of CAT as an independent assessment tool in pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD)

The benefits of PR in COPD are well recognised but the practical assessment of patients undergoing PR can be complex. The COPD assessment test (CAT) is a recently introduced simple, validated 8-item questionnaire designed to assess the impact of COPD symptoms on quality of life (QOL). We hypothesized that CAT could be used as a screening tool and outcome measure to assess QOL in COPD. 60 patients with COPD enrolled in 8 weeks outpatient PR between January 2011 and October 2011 were studied. Patients completed CAT score, chronic respiratory disease questionnaire (CRDQ), hospital anxiety and depression (HAD) at baseline and at 8 weeks. Functional status (6 min walk test (6MWT) and incremental shuttle walk test (ISWT)), dyspnoea (MRCD) and body mass index (BMI) were measured. 52 COPD patients completed the 8 weeks PR and data were available for 37 patients with mean (SD) age 68.7 (9.2) yrs and FEV1 48.64 (20.79) % predicted. There was a significant difference in 6MWT (47.03m), ISWT (47.84m), MRCD (0.3 points), CRDQ (-3.02 points), Anxiety (1.5points), depression (0.6points) and CAT (3.63 points) post PR. CAT correlated closely with CRDQ at baseline and following PR whereas there was good correlation only with ISWT, anxiety and depression post PR. CAT is an independent, simple and highly responsive outcome measure that can also be utilized for screening patients with COPD for PR

Validation of CAT as an independent assessment tool in pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD)

The benefits of PR in COPD are well recognised but the practical assessment of patients undergoing PR can be complex. The COPD assessment test (CAT) is a recently introduced simple, validated 8-item questionnaire designed to assess the impact of COPD symptoms on quality of life (QOL). We hypothesized that CAT could be used as a screening tool and outcome measure to assess QOL in COPD. 60 patients with COPD enrolled in 8 weeks outpatient PR between January 2011 and October 2011 were studied. Patients completed CAT score, chronic respiratory disease questionnaire (CRDQ), hospital anxiety and depression (HAD) at baseline and at 8 weeks. Functional status (6 min walk test (6MWT) and incremental shuttle walk test (ISWT)), dyspnoea (MRCD) and body mass index (BMI) were measured. 52 COPD patients completed the 8 weeks PR and data were available for 37 patients with mean (SD) age 68.7 (9.2) yrs and FEV1 48.64 (20.79) % predicted. There was a significant difference in 6MWT (47.03m), ISWT (47.84m), MRCD (0.3 points), CRDQ (-3.02 points), Anxiety (1.5points), depression (0.6points) and CAT (3.63 points) post PR. CAT correlated closely with CRDQ at baseline and following PR whereas there was good correlation only with ISWT, anxiety and depression post PR. CAT is an independent, simple and highly responsive outcome measure that can also be utilized for screening patients with COPD for PR