Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs

Foglio, K.; Bianchi, Luca; Bruletti, G.; Porta, Roberto; Vitacca, Michele; Balbi, Bruno; Ambrosino, Nicolino

doi:10.1016/j.rmed.2007.04.007

Cited by 89 publications

(101 citation statements)

References 39 publications

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“…These findings are in accordance with the above-mentioned studies by Dourado et al, 37 Foglio et al, 39 and Normandin et al 40 with no differences between groups.…”

Section: Effect Of Aerobic Training Intensity On Symptom Controlsupporting

confidence: 93%

“…There is evidence of a positive effect on HRQOL, as shown by studies by Bernard et al, 34 Pereira et al, 35 Montes de Oca et al, 36 Dourado et al, 37 Arnardóttir et al, 38 and Foglio et al, 39 , even considering the wide range of intensities in those heterogeneous pulmonary rehabilitation program interventions (type, modality, duration, and frequency). The multi-center study by Laviolette et al 28 with 168 subjects with COPD also found improvement in the SGRQ after the pulmonary rehabilitation program but lacked any description of the exercise intensity applied.…”

Section: Effect Of Aerobic Training Intensity On Hrqolmentioning

confidence: 93%

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Pulmonary Rehabilitation in COPD: Effect of 2 Aerobic Exercise Intensities on Subject-Centered Outcomes—A Randomized Controlled Trial

et al. 2015

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BACKGROUND: Exercise training is an important component of pulmonary rehabilitation, but it remains questionable how training intensity affects patient-centered outcomes. The aim of this study was to compare the effects of 2 aerobic training intensities on health-related quality of life (HRQOL), symptom control, and exercise tolerance in subjects with COPD. METHODS: Thirtyfour subjects with mild to very severe COPD participated in an equivalence/non-inferiority randomized controlled trial with a parallel group blinded to 60 or 80% maximum work rate (W max ) aerobic training intensity. The intervention was an out-patient pulmonary rehabilitation program conducted 3 times/week for 8 weeks. Outcomes were assessed with the St George Respiratory Questionnaire (primary outcome), Mahler's dyspnea index, London Chest Activity of Daily Living scale, 6-min walk test, and constant-load and incremental exercise tests. RESULTS: Subjects were randomly allocated to aerobic training intensity of 60% W max (group 1, n ‫؍‬ 17) or 80% W max (group 2, n ‫؍‬ 17). Although there were significant improvements in all outcomes for both groups, there were no between-group differences in mean change in the St George Respiratory Questionnaire (P ‫؍‬ .31, 95% CI ؊12.0 to 3.9), Mahler's dyspnea index (P ‫؍‬ .38), London Chest Activity of Daily Living scale (P ‫؍‬ .92), 6-min walk test (P ‫؍‬ .50, 95% CI 6.2-71.1), constant-load exercise test (P ‫؍‬ .50), and incremental exercise test (P ‫؍‬ .12). There was only one exercise-related adverse event of cardiac symptoms. CONCLUSIONS: Aerobic training intensity of at least 60% W max has a positive impact on COPD patient-centered outcomes, with no additional benefit of increasing intensity to 80% W max in HRQOL, symptom control, and exercise tolerance, challenging the present clinical attitude of rehabilitation professionals. (ClinicalTrials.gov registration NCT01944072.)

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“…These findings are in accordance with the above-mentioned studies by Dourado et al, 37 Foglio et al, 39 and Normandin et al 40 with no differences between groups.…”

Section: Effect Of Aerobic Training Intensity On Symptom Controlsupporting

confidence: 93%

Section: Effect Of Aerobic Training Intensity On Hrqolmentioning

confidence: 93%

Pulmonary Rehabilitation in COPD: Effect of 2 Aerobic Exercise Intensities on Subject-Centered Outcomes—A Randomized Controlled Trial

et al. 2015

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“…Assessing exercise capacity in an interview is difficult and prone to error, but the self-reported measure 'flights of stairs' was previously considered as reliable [Reilly et al 1999]. In many patients with COPD, the impaired exercise capacity is directly related to their quality of life [Foglio et al 2007;Dowson et al 2001]. …”

Section: Discussionmentioning

confidence: 99%

Diagnostic delay and clinical modifiers in alpha-1 antitrypsin deficiency

Köhnlein

Janciauskiene

Welte

2010

Ther Adv Respir Dis

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Abstract:Background: Alpha-1 antitrypsin deficiency (AATD) is one of the most prevalent inherited diseases in Whites, but identification of affected patients and establishment of the diagnosis is still unsatisfactory. This study assessed the latencies and numbers of physicians involved in identifying AATD patients, and the importance of smoking, vaccination status, and specific augmentation therapy on the course of the disease. Method: Patients from Germany and Austria underwent a single written interview with 28 items. Five hundred and ninety-six patients were addressed and 44.9% replied. Results: The age at symptom onset was 39.1±10.1 years, and the diagnosis was established at the age of 45.1±10.9 years. From the 6-year delay in establishing the diagnosis, 1.4±1.7 (range 0.510.5) years were due to patients' reluctance to seek medical attention. There were 3.2±2.4 (range 113) physicians involved in establishing the diagnosis. Smoking was associated with an earlier onset of respiratory symptoms and lower exercise capacity. Vaccination against pneumococci and/or influenza, and augmentation therapy resulted in significantly fewer exacerbations and fewer emergency room visits. Airway infections and passive smoking during childhood were not found to influence the onset of respiratory symptoms. Conclusions: In conclusion, there is still a large delay between symptom onset and AATD diagnosis. Smoking history, vaccination status, and augmentation therapy have an important impact on the course of the disease.

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“…In severe COPD, there is a close association between changes in a systemic and multidimensional index of performance and functional status (body mass index, airflow obstruction, dyspnoea and exercise capacity index) induced by PR and patient outcomes [22]. Several strategies have been suggested to maintain these benefits in the long term [23].…”

Section: Rehabilitationmentioning

confidence: 99%

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

Clini

Ambrosino²

2008

Eur Respir J

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Evidence-based guidelines for chronic obstructive pulmonary disease (COPD) have recently been developed.Nonpharmacological treatments have evolved rapidly as an essential part of COPD therapy. They are especially important as complementary interventions in severe or very severe disease, when there is loss in function, a reduction in quality of life and when psychological impairments further complicate the disease.The present article discusses the most used nonpharmacological treatments for severe COPD patients (rehabilitation, long-term oxygen therapy, surgery, noninvasive positive pressure ventilation and supportive nutrition) and their evidence-based usefulness in promoting strategies that relieve symptoms.All of these interventions are used during end-stage disease, to promote self-efficacy, relieve symptoms and prevent further deterioration. These therapeutic options support physicians and allied professionals in improving symptom management for their patients.

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Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs

Abstract: Despite progressive lost in effectiveness of repeated PRP, COPD patients undergoing those programs do not show any significant worsening in exercise tolerance, dyspnoea and HRQL along a period of 7 years.

Cited by 89 publications

References 39 publications

Pulmonary Rehabilitation in COPD: Effect of 2 Aerobic Exercise Intensities on Subject-Centered Outcomes—A Randomized Controlled Trial

Pulmonary Rehabilitation in COPD: Effect of 2 Aerobic Exercise Intensities on Subject-Centered Outcomes—A Randomized Controlled Trial

Diagnostic delay and clinical modifiers in alpha-1 antitrypsin deficiency

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

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