Aftercare ; Coronavirus Infections ; complications ; therapy ; Critical Care ; Equipment Design ; Humans ; Lung Diseases ; etiology ; rehabilitation ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; complications ; therapy ; Rehabilitation ; instrumentation ; Robotics

Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD) and cancer. COPD, which is characterized by an irreversible airflow limitation, exacerbates respiratory distress as the disease progresses. The prevalence of sarcopenia in stable COPD was reported to be 15% to 25% in previous foreign studies and 25% in a Korean study. As the amount of activity decreases, muscle mass decreases and eventually oxygen cannot be used effectively, resulting in a vicious cycle of deterioration of exercise capacity. Deconditioning due to decreased activity is a major cause of limb muscle dysfunction in patients with COPD. In these patients, the factors that decrease muscle strength and endurance include chronic inflammation, oxidative stress, inactivity, hypoxemia, hormone abnormality, deficits of nutrients such as protein and vitamin D, and the use of systemic corticosteroid. Therefore, treatment and management should either inhibit this process or should be directed toward supplementing the deficiency, such as with exercise, nutritional support, and medications and supplements. The relationship between sarcopenia and COPD is increasingly being reported, with some overlap in clinical features and treatments. We are fascinated to be able to diagnose 2 diseases through similar physical performance tests and to improve both diseases using the same treatment such as exercise. Therefore, this review summarizes the clinical relevance and integrative management of the 2 diseases.
Anoxia ; Chronic Disease ; Exercise Therapy ; Extremities ; Humans ; Inflammation ; Lung Diseases ; Muscle Strength ; Nutritional Support ; Oxidative Stress ; Oxygen ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Rehabilitation ; Sarcopenia ; Vitamin D

PURPOSE: The purpose of this study was to review systematically the effects of home based pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients using qualitative synthesis. METHODS: Studies designed randomized controlled trials were identified to extract data and to assess the quality of studies in 8 domestic and 3 foreign search engines, and hand search reference reviews. RESULTS: A total of 9 studies met the inclusion criteria. Overall, the methodological quality of the studies ranged from average to poor. Home based pulmonary rehabilitation consisted of exercise, education, and psychosocial interventions. Several exercises such as aerobic, strength, respiratory muscle training, and flexibility were used in home based pulmonary rehabilitation for COPD patients. Upper muscle exercise and walking were the most frequently used exercises. The most common topics for education were ‘knowledge of the illness’ and ‘drug management’. Walking distance test (WDT) and quality of life (QoL) were the most frequently measured as the dependent variables to evaluate rehabilitation outcomes, followed by pulmonary function test (PFT) and dyspnea. WDT was the most effective outcome, followed by dyspnea, QoL and PFT. CONCLUSION: This study informed about the details of scientific and effective home based rehabilitation programs in COPD patients for future researchers and clinicians. These findings can help expand the recognition and accessibility of home based rehabilitation in COPD patients.
Breathing Exercises ; Dyspnea ; Education ; Exercise ; Hand ; Humans ; Lung Diseases ; Pliability ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation* ; Respiratory Function Tests ; Search Engine ; Walking

Humans ; Lung ; Lung Diseases ; rehabilitation ; Pneumoconiosis ; rehabilitation ; Respiratory Therapy

BACKGROUND: The aim of this study was to determine the effectiveness of self-efficacy promoting pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). METHODS: thirty six patients, with clinically stable COPD were randomly assigned: 18 to a rehabilitation group and another 18 as a control group, The subjects participated in a the self-efficacy promoting pulmonary rehabilitation program for 8 weeks. This program consisted of education, breathing retraining, exercise training, relaxation and counseling. The control group received education only. The outcome variables were self-efficacy, dyspnea, exercise endurance, pulmonary function, and quality of life. Dyspnea was measured using the modified Borg scale. Exercise endurance was measured by the six minute walking distance. The quality of life was measured by the quality of life index for pulmonary disease patients. RESULTS: In the rehabilitation group after performing the self-efficacy promoting pulmonary rehabilitation program, the self-efficacy score, exercise endurance, and quality of life score were higher than the control group (p=0.007, p=0.038, and p=0.039, respectively). and the exertional dyspnea score was significantly lower than controls(p=0.045). However, the dyspnea score and FEV1 were similar after performing the self-efficacy promoting pulmonary rehabilitation program. CONCLUSION: The self-efficacy promoting pulmonary rehabilitation program is effective to in improve self-efficacy, exertional dyspnea, exercise endurance and quality of life in patients with COPD.
Counseling ; Dyspnea ; Education ; Humans ; Lung Diseases ; Outpatients* ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation* ; Relaxation ; Respiration ; Walking

Chronic obstructive pulmonary disease(COPD) is a major cause of chronic morbidity and mortality. To improve management and prevention through a concerted worldwide effort, the NIH and the WHO created the Global Initiative for Obstructive Pulmonary Disease (GOLD) and published management guideline. The guideline consists of 4 components; assessment and monitoring, avoidance of risk factors; management of stable COPD and management of exacerbation. Spirometry is essential for the diagnosis and for monitoring disease progression. Smoking cessation can reduce symptoms and prevent progression of disease. Bronchodilator therapy is the mainstay of COPD treatment. beta2-agonists, anticholinergics, and theophylline are available bronchodilators and can be used individually or in combination. Inhaled corticosteroids can also improve symptom and can be combined with bronchodilators. Inhaled corticosteroids, in addition, might reduce exacerbation frequency and severity. Non-pharmacotherapies such as rehabilitation programs and long term oxygen therapy can improve the quality of life and the survival in many patients. Stepwise increment of treatment according to the severity is recommended for stable COPD. The mainstay of treatment for acute exacerbation involves increasing bronchodilator therapy, systemic use of corticosteroids, and antibiotic therapy. In those with respiratory failure, non-invasive ventilation has been shown to reduce intubation rates, shorten lengths of hospitalization, and improve mortality.
Adrenal Cortex Hormones ; Bronchodilator Agents ; Cholinergic Antagonists ; Diagnosis ; Disease Progression ; Hospitalization ; Humans ; Intubation ; Lung Diseases, Obstructive ; Mortality ; Noninvasive Ventilation ; Oxygen ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Rehabilitation ; Respiratory Insufficiency ; Risk Factors ; Smoking Cessation ; Spirometry ; Theophylline

PURPOSE: This study was designed to investigate the effects of a pulmonary rehabilitation program for patients with COPD. METHOD: 37 subjects, who had a FEV1/FVC below 70%, participated. 18 were assigned to the experimental group and 19 to the control group. The program consisted of individualized education program and exercise program for 6weeks, 3times a week. Data was collected through questionnaire surveys of general characteristics, anxiety and depression, blood tests for lactic acid and cardiopulmonary exercise tests, and also using bicycle ergometer, for exercise capacity. As for data analyses, paired and unpaired t-test and x2-test were adopted using an SPSS program. RESULT: The result revealed that the increase in VT, peak O2, Emax, HRmax and Wmax, at the maximal exercise, were significantly high in the experimental group. However, the anxiety and depression scores were not significantly high in the experimental group. CONCLUSION: The pulmonary rehabilitation program was effective in increasing cardiopulmonary endurance in patients with COPD. Accordingly, we should seriously consider an individualized pulmonary rehabilitation program as a nursing intervention.
Anxiety ; Depression ; Education ; Exercise Test ; Hematologic Tests ; Humans ; Lactic Acid ; Lung Diseases ; Methods ; Nursing ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation* ; Statistics as Topic

BACKGROUND:Even though it is well known that pulmonary rehabilitation (PR) improves exercise capacity, and the quality of life, in patients with chronic lung disease, not many patients can attend hospital based intensive PR in Korea. The purpose of this study was to develop a method for a home-based PR program, and study its effectiveness. METHODS:Twenty patients with chronic lung diseases were randomly divided into two groups : a home PR group comprising of 10 male patients, with a mean age of 70 years, and a control group comprisiong of 10 male patients, with a mean age of 65 years. We developed exercise programs, depending on the exercise capacity of each patient, which were easy to do at home. The PR program consisted of a 12 week period of enforced aerobic (mostly walking) and muscle strengthening exercises, as prescribed by the exercise specialist, in accordance with the functional capacity of the patient. In addition to the education, nutritional and psychiatric consultation was undertaken, and respiratory muscle training arranged. Patients visited hospital every 2 weeks for evaluation and exercise prescription. RESULTS: All patients finished the 12 week course of therapy. Following the home PR, the endurance times and work capacity of the upper and lower extremities were significantly increased in the treatment group in comparison to the controls. The six minute working (Eds note : should) 'working' read 'walking'?) distance was increased from 465+/-60m to 508+/-37m and the maximal inspiratory pressure from 72.8+/-27.2cmH2O to 91.4+/-30.9 cmH2O. The quality of life, as assessed by St Georges Respiratory Questionnaire (SGRQ), was also improved following PR. (Eds note : do you have figures for before and after, and a reference for the SGRQ? i.e. for the main paper.) CONCLUSION: The home PR program we developed seemed to be applicable, and effective, to most of the patients with chronic lung diseases in the study.
Breathing Exercises ; Education ; Exercise ; Humans ; Korea ; Lower Extremity ; Lung Diseases* ; Lung* ; Male ; Prescriptions ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation* ; Specialization

BACKGROUND:Even though it is well known that pulmonary rehabilitation (PR) improves exercise capacity, and the quality of life, in patients with chronic lung disease, not many patients can attend hospital based intensive PR in Korea. The purpose of this study was to develop a method for a home-based PR program, and study its effectiveness. METHODS:Twenty patients with chronic lung diseases were randomly divided into two groups : a home PR group comprising of 10 male patients, with a mean age of 70 years, and a control group comprisiong of 10 male patients, with a mean age of 65 years. We developed exercise programs, depending on the exercise capacity of each patient, which were easy to do at home. The PR program consisted of a 12 week period of enforced aerobic (mostly walking) and muscle strengthening exercises, as prescribed by the exercise specialist, in accordance with the functional capacity of the patient. In addition to the education, nutritional and psychiatric consultation was undertaken, and respiratory muscle training arranged. Patients visited hospital every 2 weeks for evaluation and exercise prescription. RESULTS: All patients finished the 12 week course of therapy. Following the home PR, the endurance times and work capacity of the upper and lower extremities were significantly increased in the treatment group in comparison to the controls. The six minute working (Eds note : should) 'working' read 'walking'?) distance was increased from 465+/-60m to 508+/-37m and the maximal inspiratory pressure from 72.8+/-27.2cmH2O to 91.4+/-30.9 cmH2O. The quality of life, as assessed by St Georges Respiratory Questionnaire (SGRQ), was also improved following PR. (Eds note : do you have figures for before and after, and a reference for the SGRQ? i.e. for the main paper.) CONCLUSION: The home PR program we developed seemed to be applicable, and effective, to most of the patients with chronic lung diseases in the study.
Breathing Exercises ; Education ; Exercise ; Humans ; Korea ; Lower Extremity ; Lung Diseases* ; Lung* ; Male ; Prescriptions ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation* ; Specialization

OBJECTIVE: It is known that Mechanical in-exsufflator (MI-E) can reduce pulmonary complications such as pneumonia, atelectasis in tetraplegia by increasing inspiratory and expiratory capacity. The aim of this study is to clarify the effectiveness of MI-E on pulmonary function and coughing capacity in tetraplegia. METHOD: Thirty tetraplegic patients who had neither history nor radiologic finding of pulmonary disease were divided into two groups; control (n=15) and experimental (n=15) groups. Control group received conventional pulmonary rehabilitation, while experimental group received additional MI-E therapy for one month. The pulmonary function was evaluated by measuring percentage of predicted value of vital capacity (% VC), maximal insufflation capacity (MIC), unassisted peak cough flow (UPCF), volume assisted peak cough flow (VPCF), manual assisted peak cough flow (MPCF), manual and volume assisted peak cough flow (MVPCF). These data of pulmonary function before and after treatment were compared between two groups. RESULTS: 1) There are significant improvement of pulmonary function in both groups (p<0.05) except UPCF in control group before and after treatment. 2) The experimental group showed more improvement in MIC, VPCF, MPCF and MVPCF than control group (p<0.05). Conclusion: MI-E therapy can be used as an effective therapeutic modality for the improvement of pulmonary function in combination with conventional pulmonary rehabilitation.
Cough ; Humans ; Insufflation ; Lung Diseases ; Pneumonia ; Pulmonary Atelectasis ; Quadriplegia ; Rehabilitation* ; Vital Capacity