Pulmonary Rehabilitation Maintenance Program May Prevent Accelerated FEV1 Decline in Patients With COPD

Andrews, Sherry; Deoghare, Harshavardhan; Mills, Paul K.; Gundy, K. Van; Vempilly, Jose Joseph; Jain, Vipul V.

doi:10.1097/cpm.0000000000000213

Cited by 2 publications

(2 citation statements)

References 47 publications

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“…27 Five studies involving physical intervention reported significant improvement in diaphragm excursion postintervention, 14 15 28-30 while three studies reported that diaphragm excursion did not improve following intervention. [31][32][33] In addition, three studies reported links between diaphragm length and COPD where lower diaphragm length correlated with poorer prognosis and outcome. 15 34 35 Overall, clinical intervention targeting diaphragm function such as diaphragmatic breathing training programme and lung volume reduction surgery resulted in significant improvement in lung function.…”

Section: Us and Diaphragm Diaphragm Mobility And Lengthmentioning

confidence: 99%

Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review

et al. 2020

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BackgroundClinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pulmonary disease (COPD) has been widely investigated. However, there is no systematic review assessing the clinical values of non-cardiac US techniques in COPD.MethodsWe systematically searched electronic databases from inception to 24 June 2020. Two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines extracted data. A narrative synthesis of the results was conducted considering non-cardiac US techniques that looked for diaphragm, muscles and bones in patients with COPD.ResultsIn total, 2573 abstracts were screened, and 94 full-text papers were reviewed. A total of 54 studies met the inclusion criteria. Thirty-five studies assessed the diaphragm, while 19 studies evaluated different muscles, including limb muscles and pulmonary lesions in COPD using US. Of the 54 included studies, 30% (16/54) evaluated the changes in either limb muscles or diaphragmatic features before and after physical interventions; 67% (36/54) assessed the correlations between sonographic features and COPD severity. Indeed, 14/15 and 9/13 studies reported a significant reduction in diaphragm excursion and thickness in COPD compared with healthy subjects, respectively; this was correlated significantly with the severity and prognosis of COPD. Three studies reported links between diaphragm length and COPD, where lower diaphragm length correlated with poorer prognosis and outcomes. Quadriceps (rectus femoris), ankle dorsiflexor (tibialis anterior) and vastus lateralis were the most common muscles in COPD assessed by US. More than 70% (12/17) of the studies reported a significant reduction in the cross-sectional area (CSA) of the rectus femoris, rectus femoris and vastus lateralis thickness in COPD compared with healthy subjects. Quadriceps CSA and thickness correlated positively with COPD prognosis, in which patients with reduced quadriceps CSA and thickness have higher risk of exacerbation, readmission and death.ConclusionUS measurements of diaphragm excursion and thickness, as well as lower limb muscles strength, size and thickness, may provide a safe, portable and effective alternative to radiation-based techniques in diagnosis and prognosis as well as tracking improvement postintervention in patients with COPD.

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Section: Us and Diaphragm Diaphragm Mobility And Lengthmentioning

confidence: 99%

Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review

et al. 2020

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“…This disease progressively leads to chronic respiratory insufficiency, which can lead to hypoxia and hypercapnia [ 6 ], each of which is associated with poor outcomes [ 7 , 8 ]. Pulmonary rehabilitation, defined by the American Thoracic Society/European Respiratory Society (ATS/ERS) as a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behaviour change, designed by improve physical and psychological condition of people with chronic respiratory disease [ 9 ], is a cornerstone in the nonpharmacological management of COPD. Pulmonary rehabilitation has well-established benefits in improving exercise capacity, health-related quality life, and psychological well-being in chronic lung conditions in COPD patients.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of High-Flow Nasal Cannula on Pulmonary Rehabilitation in COPD Patients: A Meta-Analysis

Liu²,

Zhu

et al. 2020

BioMed Research International

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Introduction. The clinical benefit of high-flow nasal cannula (HFNC) on factors related to pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients remains unclear. This meta-analysis aimed at synthesizing the available evidence on the efficacy of HFNC on exercise capacity, lung function, and other factors related to pulmonary rehabilitation in COPD patients. Methods. Electronic databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science) were searched for randomized trials comparing with conventional oxygen therapy (COT) or noninvasive ventilation (NIV). Primary outcomes were respiratory rate, FEV1, tidal volume, oxygen partial pressure, total score of St. George’s respiratory questionnaire, 6-minute walk test, and exercise endurance time. Results. Ten trials met the criteria for inclusion. Combined data from six studies showed that HFNC showed a lower respiratory rate in COPD patients [mean difference -1.27 (95% CI: -1.65–(-0.89)]. Combined data from three studies showed a lower forced expiratory volume in one second (FEV1) in the group of HFNC. No difference in tidal volume was showed between the HFNC and control groups in COPD patients. No significant oxygen improvement between the HFNC groups and control groups. The total score of St. George’s respiratory questionnaire was improved by the subgroup analysis of HFNC versus COT but no NIV. Two multicenter RCTs showed the six-minute walk test, and statistical results showed that the length of the six-minute walk capacity was increased after usage of HFNC compared to the control group [mean difference -8.65 (95% CI: -9.12–(-8.19)]. No increase of exercise capacity after usage of HFNC (mean difference -12.65). Conclusion. In the first meta-analysis of the area, the current evidence did not show so much positive effect on tidal volume or oxygen improvement in COPD patients. Length of the six-minute walk capacity was increased after using HFNC, while other pulmonary rehabilitation parameters, namely, the score of St. George’s respiratory questionnaire and exercise capacity show no increase in the group of HFNC. The variance in the quality of the evidence included in this meta-analysis highlights the need for this evidence to be followed up with further high-quality and more randomized trials.

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Pulmonary Rehabilitation Maintenance Program May Prevent Accelerated FEV1 Decline in Patients With COPD

Cited by 2 publications

References 47 publications

Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review

Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review

Efficiency of High-Flow Nasal Cannula on Pulmonary Rehabilitation in COPD Patients: A Meta-Analysis

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