Background: Patients with advanced lung cancer tend to experience dyspnea. Pulmonary rehabilitation has been reported as a method for relieving dyspnea. However, exercise therapy imposes a high burden on patients, and it is difficult to sustain in many cases. Inspiratory muscle training (IMT) imposes a relatively low burden on patients with advanced lung cancer; however, its benefits have not been demonstrated. Methods: We retrospectively analyzed 71 patients who were hospitalized for medical treatment. The participants were divided into an exercise therapy group and an IMT load + exercise therapy group. Changes in maximal inspiratory pressure (MIP) and dyspnea were examined using a two-way repeated measures analysis of variance. Results: MIP variations significantly increase in the IMT load group, with significant differences between baseline and week 1, between week 1 and week 2, and between baseline and week 2. The analysis also showed that the variations in dyspnea decreased in the IMT load + exercise therapy group with significant differences between baseline and week 1 and between baseline and week 2. Conclusions: The results show that IMT is useful and has a high persistence rate in patients with advanced lung cancer who present dyspnea and cannot perform high-intensity exercise therapy.
Background: The purpose of this study was to investigate the effectiveness and clinical outcomes of inpatient rehabilitation for patients with severe COVID-19 in Japan. Methods: Patients with severe COVID-19 who underwent rehabilitation during hospitalization were included. The Medical Research Council (MRC) score and short physical performance battery (SPPB), such as physical function assessment and the intensive care unit (ICU) mobility scale, the functional status score for the ICU, and Barthel index as activities of daily living (ADLs) were evaluated at admission and discharge or transfer from the hospital. The correlation between SPPB at discharge and each factor at admission were also analyzed. Furthermore, the prevalence of sarcopenia was evaluated by defining SPPB of <9 points at discharge as sarcopenia. Results: The median age of the total of 23 patients was 59 years (interquartile range (IQR): 47–67), 73.9% were male, and the median PaO2/FiO2 at admission was 172.0 (IQR: 123.0–209.0). All physical function and ADL parameters were significantly improved from the time of admission to discharge (p = 0.014 for the MRC score and p < 0.001 for all others). Moreover, SPPB at discharge significantly correlated with WBC (Spearman’s rho = −0.473, p = 0.041), C-reactive protein (Spearman’s rho = −0.468, p = 0.044), and exhibited a significant trend with PaO2/FiO2 (Spearman’s rho = 0.429, p = 0.067) and age (Spearman’s rho = 0.409, p = 0.083). Although the median Barthel index at discharge was 90 points, 47% of patients had sarcopenia as defined by an SPPB of <9 points. Conclusions: Early rehabilitation for patients with severe COVID-19 improved physical function and ADLs during hospitalization. However, 47% of patients had the same level of sarcopenia at discharge.
Background Patients with advanced lung cancer tend to develop dyspnea and the usefulness of non-drug therapy. On the contrary, inspiratory muscle training (IMT) exerts a relatively lower burden on patients; however, its usefulness has not been demonstrated. This study aimed to clarify the effects and usefulness of IMT in patients with advanced lung cancer with dyspnea. Methods We retrospectively analyzed 46 patients with advanced lung cancer hospitalized for medical treatment. The participants were categorized into the exercise therapy group, which served as control, and the IMT load + exercise therapy group, who performed IMT at a load of 30–40% of the maximal inspiratory pressure (MIP) in addition to exercise therapy. Results No patient dropped out owing to IMT load. The MIP variations had a significant interaction between group and period and that those in the IMT load + exercise therapy group increased, with significant differences between baseline and week 1, between week 1 and week 2, as well as between baseline and week 2. The analysis also demonstrated that the variations of dyspnea at rest and on exertion had a significant interaction between group and period and that those in the IMT load + exercise therapy group decreased with significant differences between baseline and week 1 as well as between baseline and week 2. Conclusions This study revealed that IMT load significantly improved MIP and dyspnea in patients with advanced lung cancer. In addition, the persistence rate of IMT in these patients was high.
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