Predictors of Success for Pulmonary Rehabilitation in Patients Awaiting Lung Transplantation

Kenn, Klaus; Gloeckl, Rainer; Soennichsen, Andreas; Sczepanski, B; Winterkamp, Sandra; Boensch, Martina; Welte, Tobias

doi:10.1097/tp.0000000000000472

Cited by 57 publications

(76 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Firstly, participants with the greatest physical impairments, and thus the largest potential for improvement, dropped out of the study especially in the WBVT group due to several reasons. Literature suggests that typically participants with reduced exercise capacity benefit most from physical training [23]. Gloeckl et al demonstrated a statistically significant improvement following a WBVT intervention (+27 m) using WBVT as a complementary exercise modality on top of conventional endurance and strength training [14].…”

Section: Discussionmentioning

confidence: 99%

Whole-Body Vibration Training During a Low Frequency Outpatient Exercise Training Program in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Trial

et al. 2017

Self Cite

View full text Add to dashboard Cite

BackgroundThe aim of the study was to investigate whether whole-body vibration training (WBVT) can be applied beneficially within an outpatient low frequency exercise program.MethodsIn a prospective, controlled, randomized study, WBVT effectiveness and safety were investigated in COPD stage II-IV patients undergoing a 3-month training program. Participants took part in a 90-min circuit training once a week. On top patients were randomized to either perform squats with WBVT, or without (conventional training group (CTG)). Before and after the intervention, a sit-to-stand test (STST), a 6-min walk test (6-MWT), the COPD assessment test (CAT), and the chronic respiratory disease questionnaire (CRQ) were evaluated.ResultsTwenty-eight out of 55 patients completed the study (n = 12 WBTV, n = 16 CTG). The STST time remained nearly constant for the CTG (Δ -0.8 ± 3.1 s) and the WBVT (Δ 1.4 ± 3.2 s; P = 0.227), respectively. Similarly, for both WBVT and CTG, the 6-min walk distance remained unchanged (Δ 7 ± 55 m vs. 9 ± 45 m, P = 0.961). In three out of four categories, the CRQ scores showed a significant improvement within WBVT, and in one category when comparing across groups. The CAT score dropped by -0.8 ± 2.9 points within CTG and by 2.4 ± 2.7 points within WBVT (P = 0.105). There were no adverse events related to WBVT.ConclusionThe implementation of WBVT in the context of an outpatient low frequency exercise program did not significantly improve the patients’ exercise capacity. An improvement in CAT and partially in CRQ was shown within WBVT. However, regarding the high dropout rate (49%), these results must be interpreted with caution.

show abstract

Section: Discussionmentioning

confidence: 99%

Whole-Body Vibration Training During a Low Frequency Outpatient Exercise Training Program in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Trial

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…In clinical practice, PR training modalities do not differ between COPD patients with various genotypes. A retrospective analysis indicates that following 3 weeks' inpatient PR training, patients with A1ATD-related COPD improve less in exercise capacity than COPD patients without inherited A1ATD [12]. The reason for this difference remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Different Training-Induced Skeletal Muscle Adaptations in COPD Patients with and without Alpha-1 Antitrypsin Deficiency

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background: Pulmonary rehabilitation (PR) improves oxidative capacity of peripheral muscles in patients with chronic obstructive pulmonary disease (COPD). The exercise-induced oxidative skeletal muscle adaptation in COPD patients with inherited alpha-1 antitrypsin deficiency (A1ATD) has not been studied. Objectives: To compare PR effects on skeletal muscle adaptation in COPD patients with and without A1ATD. Methods: Nine COPD patients with A1ATD (genotype PiZZ, 6 receiving A1AT augmentation therapy), and 10 ‘usual' COPD patients (genotype PiMM) performed an incremental cycling test and underwent musculus vastus lateralis biopsies before and after a 3-week PR program including exercise training. Results: PiZZ and PiMM patients improved peak work rate following PR (+9 ± 11 W, p < 0.05, and +18 ± 9 W, p < 0.001, between-group difference p < 0.05). PiMM patients increased fibre type I (+8.1%), reduced fibre type IIA (-2.1%) and hybrid fibre type IIA/IIX proportion (-3.9%). Following PR, PiMM patients also raised mitochondrial signalling proteins PGC-1α (4.5-fold), and TFAM (6.4-fold). PiZZ patients had no change in fibre type I but showed a shift of type IIA/IIX (-8.8%) towards fibre type IIA distribution (+8.9%). The capillary to fibre ratio increased by 28% (p < 0.05) in PiZZ, whereas no change was observed in PiMM patients. Linear regression analysis revealed that diffusion capacity and A1AT therapy are predictor variables for myofibre type I response to PR (r² = 0.684, p < 0.01). Conclusions: Following a 3-week PR with comparable training modalities, PiMM but not PiZZ patients increased the oxidative myofibre type I proportion. This skeletal muscle adaptation pattern suggests better improvement of exercise capacity in PiMM than in PiZZ patients with COPD.

show abstract

“…Several studies have proven benefits from PR concerning exercise capacity and quality of life [7, 9, 25]. Similarly, in our cohort of more than 1,000 patients awaiting lung transplantation, PR was associated with improvements in 6MWD and all SF-36 domains.…”

Section: Discussionmentioning

confidence: 50%

“…Limited data demonstrate that PR is an effective treatment option for patients on the waiting list for lung transplantation and can improve quality of life and exercise capacity [6, 7]. There is increasing evidence that even patients with most advanced lung disease benefit from PR despite severely impaired functional status [8, 9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Nocturnal Noninvasive Ventilation on Pulmonary Rehabilitation in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background: Pulmonary rehabilitation (PR) in patients awaiting lung transplantation is crucial to ensure a transplant benefit. However, PR in patients with end-stage lung disease treated with noninvasive ventilation (NIV) remains an area of uncertainty. Objectives: The aim of the study was to assess the potential benefit of PR in patients awaiting lung transplantation treated with NIV. Methods: Patients awaiting lung transplantation who underwent comprehensive inpatient PR from 1998 to 2015 were retrospectively analyzed. Success of PR was assessed by comparing admission and discharge. Multivariate regression models were applied to assess the impact of long-term nocturnal NIV on PR success. Results: In total, 1,044 patients were included in the analysis. Thereof, 296 patients (28%) were treated with NIV. PR in patients treated with NIV resulted in a significant increase in 6-min walk distance (6MWD; from 250 ± 117 to 309 ± 116 m; p < 0.0001) and in various items of the Short Form Health Survey (SF)-36 questionnaire. The increase in 6MWD was higher in patients treated with NIV than in patients without NIV (59 ± 63 vs. 48 ± 55 m; p = 0.003). Furthermore, improvements of various lung function variables were higher in patients with NIV. Finally, multivariate generalized regression analysis revealed that NIV therapy was associated with improvement of 6MWD (p = 0.023) while controlling for various baseline characteristics. Conclusions: PR in patients with end-stage lung disease awaiting lung transplantation on nocturnal NIV is feasible and is associated with improvements of exercise capacity and quality of life. Furthermore, despite more advanced lung disease, patients treated with NIV have an increased benefit of PR compared to patients without NIV while awaiting lung transplantation.

show abstract

Predictors of Success for Pulmonary Rehabilitation in Patients Awaiting Lung Transplantation

Cited by 57 publications

References 31 publications

Whole-Body Vibration Training During a Low Frequency Outpatient Exercise Training Program in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Trial

Whole-Body Vibration Training During a Low Frequency Outpatient Exercise Training Program in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Trial

Different Training-Induced Skeletal Muscle Adaptations in COPD Patients with and without Alpha-1 Antitrypsin Deficiency

Impact of Nocturnal Noninvasive Ventilation on Pulmonary Rehabilitation in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

Contact Info

Product

Resources

About