Exercise Function In Patients Research Articles

Application of Nursing Intervention Based on Intelligent Grip Strength System in Patients with Tumor PICC: A Case-Control Study on Promoting Functional Exercise and Quality of Life.

Objective A case-control study was conducted to elucidate the impact of application of nursing intervention based on intelligent grip strength system in patients with tumor peripherally inserted central catheter (PICC) on promoting functional exercise and life quality. Methods A total of 100 patients with tumor PICC treated in our hospital from April 2019 to April 2021 were enrolled. The patients were randomly assigned into control group and study group. The control group received routine nursing, and the study group received nursing intervention based on intelligent grip strength system. Results First of all, we compared the nursing satisfaction between the two groups: the study group was very satisfied in 43 cases, satisfactory in 6 cases, and general in 1 case, and the satisfaction rate was 100.00%, while in the control group, 29 cases were very satisfied, 10 cases were satisfied, 6 cases were general, and 5 cases were dissatisfied. The satisfaction rate was 90.00%. As such, the nursing satisfaction of the study group was higher compared to the control (P < 0.05). Secondly, we compared the average blood flow velocity per unit time of axillary vein at different moments. Before catheterization, there exited no significant difference (P > 0.05). The average blood flow velocity per unit time of axillary vein in the study group was faster compared to the control at different time points (P < 0.05). In terms of the average blood flow velocity per unit time of axillary vein at different time points between the two groups, there exited no significant difference before catheterization (P > 0.05). But 14 and 28 days after catheterization, the average blood flow velocity per unit time of axillary vein in the study group was better when compared to the control (P < 0.05). Comparing the incidence of catheter-related complications, the incidence of catheter-related complications such as redness and swelling, phlebitis, catheter occlusion, and catheter slip in the study group (12.00%) was lower compared to the control (60.00%) (P < 0.05). There was no significant difference in vascular diameter, peak blood flow velocity, and vascular pressure between the two groups before nursing (P > 0.05), but after nursing, the vascular diameter and peak blood flow velocity group were higher, and the vascular pressure was lower in the study (P < 0.05). Comparing the scores of functional exercise compliance, the scores of grip exercise compliance, exercise monitoring compliance, active help seeking compliance, exercise attention compliance, and the total score of compliance in the study group were higher compared to the control (P < 0.05). Finally, we compared the scores of life quality. Before nursing, there exhibited no significant difference between the two groups (P > 0.05). The scores of physiological function, psychological function, social function, and health self-cognition in the study group were lower when compared to control (P < 0.05). Conclusion The utilization of intelligent grip strength system can improve the functional exercise compliance of PICC patients, effectively facilitate the venous blood circulation of upper limbs, and strengthen the life quality, as well as reduce the incidence of catheter-related thrombosis. However, more multicenter, large sample, randomized controlled studies should be carried out to explore the impact of intelligent grip strength system on the long-term effect of functional exercise in patients with PICC.

Assessment of Exercise Function in Children and Young Adults with Hypertrophic Cardiomyopathy and Correlation with Transthoracic Echocardiographic Parameters.

Exercise function is well characterized in adults with hypertrophic cardiomyopathy (HCM); however, there is a paucity of data in children and young adults with HCM. Here we sought tocharacterize exercise function in young people with HCM, understand limitations in exercise function by correlating exercise function parameters with echocardiogram parameters and identify prognostic value of exercise parameters. We performed aretrospective, single-center cohort study characterizing exercise function in patients < 26years old with HCM undergoing cardiopulmonary exercise testing (CPET). Patients with syndromic HCM or submaximal effort were excluded. We compared exercise function in this cohort to population normal values and measured changes in exercise function over time. We correlated exercise function parameters with echocardiographic parameters and investigated the relationship between exercise test parameters and a clinical composite outcome comprised of significant ventricular arrhythmia, death, or heart transplantation. We identified 229 CPETs performed by 117 patients (mean age at time of first CPET 15.6 ± 3.2years). Mean %-predicted peak VO2, O2 pulse, and peak heart rate were statistically significantly depressed compared to population normal values and exercise function gradually worsened over time. Abnormal exercise testing correlated closely with echocardiographic indices of diastolic dysfunction. There was a trend toward increased incidence of poor clinical outcome in patients with abnormal exercise function.While adverse clinical outcomes were rare, normal exercise function appears to be a marker of low risk for adverse clinical outcomes in this population.

Effects of intelligent grip strength system in functional exercise of patients with PICC

Effects of intelligent grip strength system in functional exercise of patients with PICC

Effectiveness of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury: a randomized controlled trial.

Singing, as a method of combining respiratory function exercise and vocal intonation therapy, provides a new direction for respiratory function exercise in patients with spinal cord injury. This randomized controlled trial investigated the effects of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury. Among 31 included patients with spinal cord injury, 18 completed the treatment. These 18 patients were randomly assigned to undergo music therapy (intervention group, 30 min/d, 5 times a week, for a total of 12 weeks; n = 9, 7 males and 2 females; 30.33 ± 11.74 years old) or normal respiratory training (control group, n = 9; 8 males and 1 female; 34.78 ± 11.13 years old). Both patient groups received routine treatment concurrently. Before and at 6 and 12 weeks after intervention, a standard respiratory function test, a voice test, the St. George's Respiratory Questionnaire, and a quality of life questionnaire were administered. The results showed that the inspiratory capacity, forced expiratory volume in 1 second, forced vital capacity, maximal mid-expiratory flow rate, sing-loud pressure level, and sustained note length were significantly increased in the intervention group compared with the control group. The St. George's Respiratory Questionnaire and quality of life results of patients in the intervention group were significantly superior to those in the control group. These findings suggest that oral motor respiratory exercise and vocal intonation therapy, as respiratory training methods in music therapy, are effective and valuable for improving respiratory dysfunction and vocal quality in patients with spinal cord injury. This study was approved by the Ethics Committee of China Rehabilitation Research Center (approval No. 2019-78-1) on May 27, 2019 and was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1900026922) on October 26, 2019.

Clinical observation on improving the compliance of functional exercise of patients after joint replacement by medical care combined with ward-visit

Objective:To investigate the effect of combined medical and nursing visits on improving the compliance of functional exercise after arthroplasty.Methods：40 cases of joint replacement in January-December 2016 were treated as control group and 40 cases of joint replacement in January-December 2017 as experimental group. In the control group, separate ward-round mode was adopted, and in the experimental group,combined ward-roundmode was adopted. The compliance and patient sasfstction of 2 groups of functional exercise were compared.Results： The compliance of the two groups was significantly higher than that of the control group, and the satisfaction of the patients was significantly higher than that of the control group. The difference was statistically significant (P <0.05）Conclusion: It is worth popularizing in clinical practice that the joint replacement patients can improve the compliance of the patient's functional exercise and improve the patient's satisfaction.

Application of cross-theoretical model combined with family empowerment theory in postoperative functional exercise of patients with breast cancer

Objective To explore the application of cross-theoretical model and family empowerment theory in functional exercise of postoperative patients with breast cancer, and to provide theoretical basis for clinical nursing intervention. Methods A total of 90 patients who underwent radical mastectomy in the First Affiliated Hospital of Air Force Military Medical University from January to October 2018 were selected for the study. A total of 45 patients admitted to the hospital from January to May 2018 were assigned into the control group, and 45 patients admitted to the hospital from June to October 2018 were put into the observation group. Patients in the control group were treated with conventional breast cancer surgery, and the benefits and methods of functional exercise were informed. Patients in the observation group were treated with a family empowerment program in conjunction with interventions based on the cross-theoretical model. The effect of the intervention was evaluated using the Positive Aspects of Caregiving and the Anxiety Self-Assessment Scale. Results There was significant statistical difference in the change stage between the two groups after the intervention (P<0.05) , the average daily exercise time of the observation group was longer than that of the control group, and the difference was statistically significant (P<0.05) . After intervention, the total score and dimension scores of Positive Aspects of Caregiving in the observation group were higher than those of the control group with statistical significances (P<0.05) . The scores of Self-rating Anxiety Scale in the observation group was lower than those in the control group after the intervention with statistical significance (P<0.05) . Conclusions The cross-theoretical model combined with family empowerment theory can improve the breast cancer patients' compliance of functional exercises, reduce their anxiety levels, and improve the positive feelings of caregivers. Key words: Breast neoplasms; Anxiety; Caregiver; Cross-theoretical model; Family empowerment theory; Positive feeling

Research progress of functional exercise in patients with catheterization by PICC

This article reviews the research status of functional exercise in patients with catheterization by peripherally inserted central catheters (PICC) . This study describes the functional exercise method, exercise start time, exercise frequency and duration, exercise intensity and intervention effect, and provides references for guiding health education, discharge guidance and nursing intervention for patients with catheterization. Key words: Review; Complications; Peripherally inserted central catheters; Functional exercise

Nursing intervention for respiratory function exercise in patients with silicosis complicated by stable chronic obstructive pulmonary disease

Objective: To investigate the clinical effect of nursing intervention for respiratory function exercise in patients with silicosis complicated by stable chronic obstructive pulmonary disease (COPD) . Methods: A total of 60 patients with silicosis complicated by stable COPD who were hospitalized in Department of Occupational Diseases, Laigang Hospital Affiliated to Taishan Medical College, from August 2017 to April 2018 were enrolled and randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were given routine treatment and respiratory function exercise, and those in the observation group were given nursing intervention in addition to the treatment in the control group. The two groups were compared in terms of pulmonary function, blood gas parameters, and six-minute walk distance before intervention and after 2 months of intervention. Results: After intervention, the observation group had significantly higher forced expiratory volume in 1 second (FEV(1)) , forced vital capacity (FVC) , arterial partial pressure of oxygen (PaO(2)) , and six-minute walk distance than the control group (P<0.05) , while there were no significant differences between the two groups in FEV(1)/FVC and partial pressure of carbon dioxide (P>0.05) . Conclusion: Nursing intervention can effectively improve FEV(1), FVC, PaO(2), and 6-minute walking distance in patients with silicosis complicated by stable COPD.

Application of early functional exercise in patients with shoulder-hand syndrome after acute stroke

Objective To explore the effects of early functional exercise on the patients with shoulder-hand syndrome after acute stroke. Methods Totally 60 patients with shoulder-hand syndrome after acute stroke who were admitted in Zhejiang Hospital between January 2015 and January 2017 were prospectively selected and randomly divided into an observation group (n=30) and a control group (n=30) . Patients in the observation group performed early functional exercise, while patients in the control group received only routine nursing. The clinical effect was compared between the patients in the two groups. Results There was no statistically significant difference in the scores for the swelling of the limb, the range of movement of metacarpophalangeal joints and the simple upper limb function before the intervention (P>0.05) . After two weeks and four weeks of intervention, the swelling of the limb in the patients in the observation group was lower than that of the patients in the control group (P 0.05) . After four weeks of intervention, the patients in the observation group showed lower scores of anxiety and depression than the patients in the control group (P<0.05) . Conclusions Early functional exercise helps to improve the function of limbs, lower the level of anxiety and depression, and improve the quality of life in patients with shoulder-hand syndrome after acute stroke. Key words: Reflex sympathetic dystrophy; Anxiety; Depression; Acute stroke; Early functional exercise

The Effect of Functional Movement Training After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

To evaluate the effect of functional movement screen (FMS)-based functional exercise in patients after anterior cruciate ligament reconstruction (ACLR). Randomized, controlled, single-blind trial. Institutional, single center. A total of 38 patients who underwent ACLR were recruited and randomly assigned to group 1 (n = 19) or group 2 (n = 19). Both groups received 6-month routine rehabilitation immediately after surgery. From the postoperative fourth to sixth month, group 1 received FMS-based functional exercise plus routine rehabilitation and group 2 received routine rehabilitation only. The FMS-based functional exercise was individualized and customized functional corrective exercise, which was designed based on the 3-month postoperative FMS results. The frequency of rehabilitation was 1 hour per session, twice a week, for a total duration of 6 months. At 3 and 6 months postoperatively, patients were evaluated by FMS scoring, Lysholm Knee Score, and International Knee Documentation Committee 2000 Score. After the intervention, both groups had significantly increased FMS, Lysholm Knee Score, and International Knee Documentation Committee 2000 score. Group 1 had significantly greater changes in FMS (median: 4 vs 3, P < .001), Lysholm Knee Score (median: 24 vs 16, P = .001), and International Knee Documentation Committee 2000 Score (median: 22 vs 8, P < .001) than group 2. The application of FMS-based functional exercise to patients after ACLR resulted in significant improvement in knee function and movements. The authors suggested integrating FMS evaluation and FMS-based training into routine post-ACLR rehabilitation programs.

Research on compliance of breathing exercise and demands of animation education in patients with lung cancer after sugery

Objective To investigate the compliance of breathing exercise and demands of animation education in postoperative patients with lung cancer. Methods Totally 99 postoperative hospitalized patients with lung cancer in the department of thoracic surgery were enrolled in this study from September 2015 to March 2016. The survey was conducted by postoperative breathing exercise compliance questionnaire and animation education demands questionnaire. Results The average score of breathing exercise compliance in patients with lung cancer was (37.23±11.58). Single factor analysis showed that the compliance was significantly affected by the education level and the preoperative health education (t=25.641, 6.327; P<0.05). On the demand of animation education with breathing exercise, 58.6% of patients extremely intended to watch education cartoons; 61.8% of patients preferred type of life story animation; 34.3% of patients preferred cartoon characters; 48% of the patients were likely to choose cattoons within 10 min; and 50% of the patients preferred the daily cartoon within besides their beds. Conclusions The compliance of postoperative pulmonary function exercise in patients with lung cancer is negative, and medical staff can choose the education animation according to patients′ individual preferences to improve the patients compliance of the breathing exercise maximally, so as to improve the quality of life of postoperative patients with lung cancer. Key words: Lung cancer; Breathing exercise; Compliance; Animation education

Systematic evaluation of the clinical nursing pathway with the GRADE approach applied to functional exercise in patients with hip replacements before and after surgery

Abstract Objective To evaluate the effect of the clinical nursing pathway applied to functional exercise in patients with hip replacements before and after the operation. Methods The China National Knowledge Infrastructure (CNKI), WanFang Data, Chinese science and technology journal database (VIP), PubMed, Web of Science, EMBASE, CBM and the Cochrane Library (2015-5) were searched for randomized controlled trials (RCTs) on clinical nursing pathways for functional exercise in patients with hip replacements before and after surgery from June 2015 to January 2010. The references included in the literature were also retrieved. To meet the literature standard, 2 reviewers independently selected and extracted data according to the inclusion criteria and assessed the risks of bias. RevMan 5.3 software was used in this meta-analysis. The quality of evidence was evaluated using grade profiler3.6 software, the level recommended for grading. Results A total of 15 RCTs and 1248 patients were included. The meta-analysis showed that, in the clinical nursing path group, the Harris score of hip function [SMD = 3.35, 95% CI (2.53, 4.16), P CI (0.15, 0.53), P CI (0.14, 0.82), P = 0.02], urinary retention [RR = 0.22, 95% CI (0.09, 0.52), P = 0.0005], constipation [RR = 0.20, 95% CI (0.10, 0.40), P CI (1.17, 1.36), P CI (−2.39, −1.43), P CI (0.05, 1.15), P = 0.08], pressure ulcers [RR = 0.25, 95% CI (0.03, 2.19), P = 0.21], and incidence of complications [RR = 0.42, 95% CI (0.15, 1.12), P = 0.08], there was no statistically significant difference between the two groups. Funnel plot analysis of the average length of stay showed that there might be some publication bias in the literature. The GRADE evaluation results showed that the level of Harris scores for hip function was moderate and the incidence of thrombosis, urinary retention and satisfaction of patients regarding nursing were low, and the rest of the factors analyzed were very low. Conclusions The effect of the clinical nursing pathway applied to functional exercises in patients with hip replacements before and after surgery was significantly better than that of routine nursing. However, it was restricted by the evaluation grade of the research results and the standardization and uniformity of the research. The results of the above study need to be verified by more high-quality RCTs.

Effect of daily log combined with multimedia technology on functional exercise in patients with ankylosing spondylitis

Objective To investigate the effect of daily log combined with multimedia technology on functional exercise in patients with ankylosing spondylitis. Methods A total of 61 patients were randomly assigned to experimental group (31) and control group (30). Two groups of patients accept the same drug therapy. The patients in the experimental group underwent multimedia course and synchronous training of function excise guided by simultaneous video, and they were requested to write daily log about functional exercise. The patients in the control group took use of conventional health education and conventional functional exercise guidance. We assessed patients by Bath ankylosing spondylitis functional index (BASMI), Bath ankylosing spondylitis metrology index (BASFI) and functional exercises compliance at pre-and post-treatment three months. Results In the experimental group, BASMI score decreased from (4.6±1.8) to (2.6±1.6) and BASFI score decreased from (47.67±17.31) to (16.72±12.91). In the control group BASMI score reduced from (4.7±1.7) to (3.5±1.3) and BASFI score declined from (48.01±16.86) to (23.83±13.03). The difference of BASMI score and BASFI score between these two groups were significant at post-treatment (t=3.125, 3.213; P<0.01). The excellent rates of functional exercises compliance were indifferent between two groups before intervention, but it increased to 83.9% in the experimental group and the number was 46.7% in the control group at three month post-treatment (P<0.01). Conclusions Daily log combined with multimedia technology applies for patients with ankylosing spondylitis contributing them to master the method of functional exercise, and the spinal motion and body function can be significantly improved after three months′ intervention. Key words: Spondylitis, ankylosing; Daily log; Multimedia technology; Functional exercise

Cardiopulmonary exercise capacity and ventilation effectiveness in patients after clinical cure of acute irritant gas poisoning.

The aim of this study is to assess the medium to long-term effect of acute irritant gas poisoning on cardiopulmonary exercise function in patients after clinical cure. Fourteen patients after an average of 18.5 months of clinical cure of acute irritant gas poisoning were recruited, and 14 healthy individuals were selected as control. All subjects were examined by resting pulmonary function testing (RPFT), cardiopulmonary exercise testing (CPET), and arterial blood gas (ABG) analysis. No statistically significant differences were found between poisoning and control groups for baseline parameters (age, height, and weight) or ABG values (pH, PaO2, PaCO2, and SaO2) (P > 0.05). For most RPFT parameters, including FEV1/FVC, FEV1, FEV1%pred, RV/TLC, DLCO%, and FVC%, no statistically significant differences were observed between poisoning and control groups (P > 0.05). However, MVV% was significantly lower in poisoning group compared with healthy individuals (P < 0.05). Statistically significant differences were observed for some CPET parameters, including peak VO2, peak VO2/kg, peak VE, and lowest VE/VCO2 (P < 0.05), and peak load, V D/V T, and peak PETCO2 (P < 0.01) between the two groups. However, there were no statistically significant differences in peak VO2%pred or peak O2 pulse between poisoning and control groups (P > 0.05). Compared with controls, patients with acute irritant gas poisoning had decreased cardiopulmonary exercise capacity and ventilation effectiveness after clinical cure.

Normalized Cardiopulmonary Exercise Function in Patients With Pectus Excavatum Three Years After Operation

During exercise cardiac function is often limited in patients with pectus excavatum. Therefore, we hypothesized that cardiopulmonary exercise function would improve after the Nuss procedure. Seventy-five teenagers (49 patients, 26 controls) were investigated at rest and during bicycle exercise before surgery, and 1 year and 3 years postoperatively (after pectus-bar removal). Echocardiography and lung spirometry were performed at rest. Cardiac output, heart rate, and aerobic exercise capacity were measured using a photoacoustic gas-rebreathing technique during rest and exercise. Forty-four patients and 26 controls completed 3 years follow-up. Preoperatively, patients had lower maximum cardiac index, mean ± SD, 6.6 ± 1.2 l·min(-1)·m(-2) compared with controls 8.1 ± 1.0 l·min(-1)·m(-2) during exercise (p = 0.0001). One year and 3 years postoperatively, patients' maximum cardiac index had increased significantly and after 3 years there was no difference between patients and controls (8.1 ± 1.2 l·min(-1)·m(-2) and 8.3 ± 1.6 l·min(-1)·m(-2), respectively [p = 0.572]). The maximum oxygen consumption was unchanged. Left ventricular dimensions increased in patients over 3 years; however, no difference was seen between the 2 groups. Preoperatively, patients had lower forced expiratory volume in the first second of expiration (FEV1; 86% ± 13%) as compared with controls (94% ± 10%), p = 0.009. Postoperatively, no difference was found in FEV1 between the 2 groups. Before operation, FEV1 and maximum cardiac index were lower in patients compared with healthy, age-matched controls. One year after, both parameters had increased, although only FEV1 had normalized. After 3 years and bar removal, cardiopulmonary function in patients during exercise had normalized.

Natural history of exercise function in patients with Ebstein anomaly: A serial study

The clinical manifestations of Ebstein anomaly (EA) vary greatly; criteria for surgical intervention remain undefined. Decisions regarding surgical intervention in asymptomatic/mildly symptomatic patients would be helpfully informed by a detailed, quantitative understanding of the natural history of exercise intolerance in these patients. However, past studies of exercise function in EA have been of a cross-sectional, rather than a serial, nature. We, therefore, analyzed serial cardiopulmonary exercise (CPX) tests from patients with unrepaired EA to better appreciate the natural history of their exercise function. All patients with EA who had had at least 2 CPX tests, separated by at least 6 months, between November 2002 and October 2010 were identified. Patients with prior tricuspid valve surgery were excluded from the study. Cardiopulmonary exercise data from 23 patients (64 CPX tests; 2.8 ± 1.0 tests/patient) were analyzed. The median time interval between the first and last CPX tests was 3.3 (range, 0.6-7.3) years. The percentage of predicted peak oxygen consumption declined slowly (1.87 ± 8.04 percentage points/y) during the follow-up period. The decline was more pronounced (3.04 ± 6.78 percentage points/y) in patients <18 years old. On multivariate modeling, only the change in oxygen pulse at peak exercise (a surrogate for forward stroke volume) and the change in peak heart rate over time emerged as statistically significant correlates of the change in percentage of predicted peak oxygen consumption. The exercise function of patients with EA tends to deteriorate over time. This deterioration appears to be related to a progressive decline in their ability to augment their forward stroke volume and heart rate during exercise.

Investigation on compliance and its influential factors of postoperative functional exercise for patients with joints replacement

Objective To investigate the compliance of postoperative functional exercise for patients with joints replacement and analyze on its influential factors. Methods 120 patients with joints replacement were investigated with a self-compiled evaluation form of compliance of postoperative functional exercise and its influential factors. Results Compliance of postoperative functional exercise is not good, the total compliance rate is only 25%; the factors affecting the compliance included dependence, poor comprehension and identification of the importance to the functional exercise, pain, worrying about joints displacement, out of strength and insufficient instruction from the stuff ( P ＜ 0. 05 ). Conclusions Intervention based on the factors affecting the compliance could help to improve t he compliance of post-operative functional exercise in patients with joints replacement. Key words: Joints replacement; Functional exercise; Compliance; Influential factors

The analysis of functional exercises sitnation of the patients after total hip arthroplasty

Objective To understand the functional exercise situation of the total hip arthroplasty(THA)patients in hospital. Methods Using self-designed functional exercise in patients with TKA outline the structure of observation, observation and collection of Orthopedic Surgery,71 cases (91 hips)received THA in patients with relevant information. Results After the former 3d,22.5% of patients did not exercise;After 14 d continuous passive motion (CPM) ,hip joint exercises were separately accounted for 71.8% and 81.7% ,and static muscle contraction,straight leg raising were accounted for 40.8 percent and 81.7 percent. The four exercise started lately, training methods were not standardized the patients, insisted on a shorter time;single-and double-hip replacement hip replacement in patients with Shimoji routing practice started time respectively, after (6.51 ± 2.90 ) d and ( 10.30 ± 3.21 ) d. In the functional exercise process,CPM was assisted by nurse,in other exercises was assisted by retaining workers and patients families. Conclusion THA patients hospitalized during the actual exercise of the number,frequency,timing and methods vary, nursing staff should be further explored how to ensure that patients really effective rehabilitation exercise to further enhance the effect of patients with rehabilitation exercises. Key words: Arthroplasty, hip; Physical exercise; Functional recovery; Rehabilitation care

Effect of tumor vascular invasion upon cardio-pulmonary exercise functions in patients with lung cancer

To investigate the correlation between the tumor vascular invasion and the change of cardio-pulmonary exercise function in patients with lung cancer. The cardio-pulmonary exercise test was performed in 405 patients with lung cancer (293 with vascular invasion and 112 without). The peak load indices examined included maximal work power (measured value/predicted value, W%), maximal oxygen uptake per weight (VO(2)/kg), anaerobic threshold (AT), maximal oxygen pulse (measured value/predicted value, VO(2)/HR%), maximal minute ventilation (V(E)), maximal breath reserve (BR), maximal breath frequency (BF) and maximal tidal volume during expiration (VTex). (1) W%, VO(2)/kg, AT, VO(2)/HR% of patients with vascular invasion [(73 +/- 18)%, (17 +/- 5) ml * min(-1) * kg(-1), (51 +/- 14)%, (79 +/- 18)% respectively] decreased than those without vascular invasion [(86 +/- 20)%, (19 +/- 5) ml * min(-1) * kg(-1), (55 +/- 14)%, (88 +/- 20)% respectively, all P < 0.01) while BF increased [(32.1 +/- 6.1)/min vs (30.6 +/- 5.1)/min, P < 0.05). (2) The patients were divided according to TNM stage, number, kind of tumor vascular invasion and its relationship with tumor, W%, VO(2)/HR% decreased in the groups of 1-, 2- and >or= 3-vessel invasion versus the control group (P < 0.01), AT decreased in the groups of 1- and >or= 3-vessel invasion versus the control group (P < 0.05, P < 0.01), VO(2)/kg decreased in the groups of 2- and >or= 3-vessel invasion versus the control group (P < 0.05, P < 0.01), VO(2)/kg decreased in the group of >or= 3-vessel invasion versus 1- and 2-vessel invasion (P < 0.05 or P < 0.01), VO(2)/HR% decreased in the group of >or= 3-vessel invasion versus 1-vessel invasion (P < 0.01), VTex decreased in the group of >or= 3-vessel invasion versus the control group and 1-vessel invasion (P < 0.05). There was correlation between VO(2)/HR% and the number of tumor invaded vessels (r = 0.220, P < 0.01). The amount of oxygen uptake, exercise ability and cardiac function during exercise decrease in patients of lung cancer with tumor vascular invasion. The main reason is the number of the invaded vessels.

Impact of Pulmonary Artery Pressure on Exercise Function in Severe COPD

Although pulmonary hypertension commonly complicates COPD, the functional consequences of increased pulmonary artery pressures in patients with this condition remain poorly defined. We conducted a cross-sectional analysis of a cohort of 362 patients with severe COPD who were evaluated for lung transplantation. Patients with pulmonary hemodynamics measured by cardiac catheterization and available 6-min walk test results were included. The association of mean pulmonary artery pressure (mPAP) with pulmonary function, echocardiographic variables, and 6-min walk distance was assessed. The prevalence of pulmonary hypertension (mPAP, > 25 mm Hg; pulmonary artery occlusion pressure [PAOP], < 16 mm Hg) was 23% (95% confidence interval, 19 to 27%). In bivariate analysis, higher mPAP was associated with lower FVC and FEV(1), higher Pco(2) and lower Po(2) in arterial blood, and more right heart dysfunction. Multivariate analysis demonstrated that higher mPAP was associated with shorter distance walked in 6 min, even after adjustment for age, gender, race, height, weight, FEV(1), and PAOP (-11 m for every 5 mm Hg rise in mPAP; 95% confidence interval, -21 to -0.7; p = 0.04). Higher pulmonary artery pressures are associated with reduced exercise function in patients with severe COPD, even after controlling for demographics, anthropomorphics, severity of airflow obstruction, and PAOP. Whether treatments aimed at lowering pulmonary artery pressures may improve clinical outcomes in COPD, however, remains unknown.