Improvement In FVC Research Articles

S7 Nitrofurantoin Lung Toxicity - Are Steroids Useful?

Background Recurrent urinary tract infections are common and current UK guidelines advocate prophylaxis with nitrofurantoin in selected patients 1 . Nitrofurantoin-induced pulmonary toxicity (“Nitrofurantoin lung” or NL) is uncommon but can result in progressive respiratory failure. Locally we have observed a rise in NL. Pulmonary toxicity necessitates cessation of nitrofurantoin, however the utility of additional corticosteroid therapy remains controversial 2 . We examined a detailed case series to ascertain the effect of drug cessation alone and addition of oral corticosteroids in NL. Methods Using a local Interstitial Lung Disease database, we retrospectively identified patients who had presented with NL between 2009–2013. Patient demographics, imaging, pulmonary function and prescribing data were accessed. Local and national nitrofurantoin prescribing rates were also reviewed. Results Scottish prescribing data demonstrated increased community nitrofurantoin prescriptions from 3.4 to 11 items/1000 patients from 2008–2012. Our database identified 13 NL cases (93% female, mean age 74 years, range 63–83). All had a history of chronic cystitis and presented with chronic NL. Cumulative lung function (available in 9 patients) demonstrated a mean improvement in% predicted FVC and FEV 1 of +33 (p = 0.009) and +37 (p = 0.006), respectively, following cessation of nitrofurantoin. 44% of patients were also prescribed oral prednisolone. Comparing these two groups (cessation + steroid vs cessation alone) showed no significant difference in mean% predicted FVC (p = 0.47) or FEV 1 (p = 0.87), gender, age or imaging at diagnosis. Following treatment, there was no significant difference in% predicted FVC (p = 0.87) or FEV 1 (p = 0.93) between groups. The mean% predicted FVC improvement was 31% in the steroid group and 34% in the cessation only group, showing no significant difference between groups (p = 0.86). Conclusions With increased nitrofurantoin prescribing, the prevalence of NL will continue to rise throughout the UK and heightened awareness of the condition will be required in primary and secondary care. Our data demonstrates that significant improvements in lung function occur on cessation of nitrofurantoin and suggests no benefit is conferred by additional use of corticosteroid in patients with chronic NL. References Management of infection guidance for primary care (2012). http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1279888711402 Mendez et al . Chronic nitrofurantoin-induced lung disease. Mayo Clin Proc 2005;80(10):1298-302

The application of impulse oscillation system for the evaluation of treatment effects in patients with COPD

There are only a few reports of the use of impulse oscillation system (IOS) for the evaluation of COPD treatment. In this study, we applied IOS and spirometry to evaluate the effectiveness of fluticasone propionate and salmeterol (SFC) combined with tiotropium (TIO) in COPD patients. Following a 4-week run-in period with TIO (18μg once daily) treatment, COPD patients were randomized to SFC (250/50μg twice daily; SFC+TIO group, n=25), or TIO alone (TIO group, n=31). Pulmonary functions were recorded by IOS and spirometry before and after the study period. The SFC+TIO group showed significant improvements in inspiratory resistance at 5Hz and resonant frequency, as well as in FVC and FEV1, after the 12-week treatment (p<0.05). Since there were no significant correlations between improvements in IOS measurements and FVC or FEV1, IOS may provide a physiological point of view that is different from spirometry and seemed to be applicable as an additional assessment tool targeting COPD patients.

Role of laser acupuncture in chronic respiratory diseases

BackgroundUse of laser makes efficient acupuncture application without the use of stainless steel needles. Irradiation with laser of acupuncture points can produce effects of diminishing inflammation, relieving pain, enhancing metabolism, improving tissue regeneration and immunity. ObjectivesTo discuss its efficacy as non-pharmacological intervention that may provide a valuable adjunctive or alternative treatment for chronic respiratory diseases. Subjects and methodsIndications were 31 patients suffering from chronic respiratory illness (asthma, COPD, bronchiectasis and ILD). They were subdivided into a control group that received conservative treatment with medication and a study group that received a 10day course of LLL in addition to medication. All patients were subjected to full history taking, Plain Chest X-ray and HRCT chest. Parameters assessed before and after 10days: BMI, flow/volume loop and treadmill 6MWT. Main resultsThere was no statistically significant difference in the mean value of age, BMI and sex difference between both groups. Also there was no statistically significant difference regarding baseline spirometric data and 6 MWD between both groups. There was a statistically significant improvement in FVC, FEV1, FEF 25–75% and 6 MWD after 10days of laser when compared with baseline data within the study group, while within the control group there was a statistically significant improvement in FVC, FEV1 and 6 MWD after 10days of medical treatment when compared with baseline data. By comparing both groups, there was more significant improvement in FEV1 and 6 MWD after 10days of laser when compared to the control group. ConclusionA ten-day course of LLL may be a useful adjunct to standard medical care for chronic respiratory diseases, though this requires corroboration with larger studies.

P80 ‐ An evaluation of the efficacy and safety of a dust mite sublingual immunotherapy in allergic asthmatic children: a retrospective clinical data analysis over a three‐year period

Results The results of this study showed that SLIT group has a highly statistically significant reduction in the use of daily doses of the combination treatment (budesonide / formoterol) (p<0.0001), in comparison to control group (p=0.397). In addition, in the SLIT group there were 97% of the patients totally stopped both control and reliever medications in the final six months and only continued with SLIT. Moreover, there were more improvements in FVC and FEV1 in SLIT compared to control group. Additionally, these results revealed that SLIT significantly reduced the clinical outcome scores. There were no systematic (anaphylaxis) side effects reported with SLIT. Conclusions The results of this study suggest that SLIT has a significant role in controlling AA due to dust mite in children. Besides, the results suggest that SLIT is a safe medication for children with AA. Caution must be applied when using the results of this study in practice due to the retrospective design of this study, which means that the findings may not be transferable to routine clinical practice.

The potential additional benefit of infliximab in patients with chronic pulmonary sarcoidosis already receiving corticosteroids: A retrospective analysis from a randomized clinical trial

Infliximab, a TNF-alpha antagonist, has shown efficacy in the treatment of sarcoidosis. Since corticosteroids inhibit TNF-alpha expression, we postulated that sarcoidosis patients receiving a sufficient corticosteroid dose may have an attenuated response to the addition of infliximab. We analyzed data from a previous randomized double blind prospective trial of infliximab versus placebo for chronic pulmonary sarcoidosis. The effect of the maintenance corticosteroid dose on the change in FVC % predicted between 0 and 24 weeks (ΔFVC%pred0-24) was analyzed in two ways. First, the mean ΔFVC%pred0-24 was calculated for the placebo and infliximab groups using three different daily prednisone equivalent dose thresholds: a) <10mg versus ≥10mg; b) <15mg versus ≥15mg; c) <20mg versus ≥20mg. Second, in both the placebo and infliximab groups, a correlation coefficient was calculated between the maintenance corticosteroid dose and ΔFVC%pred0-24. Both the group that received infliximab and either a maintenance daily dose of <10mg of prednisone and the group receiving ≥10mg had a significant increase in FVC%pred0-24. However, both the groups that received infliximab and a corticosteroid dose of >15mg of prednisone and ≥20mg of prednisone did not demonstrate a significant ΔFVC%pred0-24. For the placebo group, there was no significant correlation between the corticosteroid dose and the ΔFVC%pred0-24. For the infliximab group, there was a significant correlation (p=0.0097) between higher corticosteroid dose and less improvement in FVC%pred0-24. Our results suggest that infliximab adds minimal potential benefit to corticosteroids for pulmonary sarcoidosis at doses above 15-20mg/day of prednisone.

Evaluation on therapeutic effects of tiotropium combined with salmeterol and fluticasone in treatment of stable COPD patients of group C

Objective To investigate the therapeutic effects of combination treatment of tiotropium plus salmeterol and fluticasone in the treatment of stable chronic obstructive pulmonary disease (COPD) patients of group C.Methods 60 subjects with stable COPD in group C classified by combined COPD assessment,were randomly divided into a treatment group (n=30) and a control group (n=30).The treatment group was treated with tiotropium(1 8 μ g,inhalation,once daily) plus salmeterol and fluticasone (50,500 μ g,inhalation,twice a day) and the control group was treated only with ipratropium bromide and albuterol aerosol according to the needs.The exercise tolerance and lung function were measured before and 8 weeks after the treatment respectively.Results 8 weeks after the treatment,there were improvements of 6 minute walk test compared with baseline and the control group,significantly greater improvements in the FVC,FEV1 and FEV1％ pred were seen in the treatment group at all time points(P＜O.05).FVC,FEV1 and FEV1％ pred 8 weeks after treatment were higher than those before treatment in both two groups(P＜O.05),but there was a significant difference between the treatment group and the control group (P＜O.05).Conclusion Combination treatment with tiotropium,salmeterol and fluticasone inhalation has greater therapeutic benefits than ipratropium bromide or albuterol aerosol inhalation alone in stable COPD patients of group C. Key words: Chronic obstructive pulmonary disease (COPD); Tiotropium; Salmeterol/Fluticasone

Real life clinical study design supporting the effectiveness of extra-fine inhaled beclomethasone/formoterol at the level of small airways of asthmatics

BackgroundIn an attempt to establish how treatment with inhaled extra-fine beclomethasone/formoterol (I-EF-BDP/F) formulation differs from other combinations of inhaled corticosteroid (ICS) and long acting beta-agonist (LABA), we studied lung function and markers of airway inflammation upon switching to the extra-fine formulation and after 8 weeks of treatment with it. MethodsWe carried out a real-life clinical observation of undercontrolled asthmatic patients switched over from dry powder inhalers of fluticasone/salmeterol and budesonide/formoterol to I-EF-BDP/F (Foster®, Chiesi Farmaceutici S.p.A., Italy). The effects of 8-weeks of treatment were documented by means of visual analog scale (VAS), quality of life by Asthma Quality of Life Questionnaire (AQLQ), spirometry and markers of airway or systemic inflammation: exhaled breath temperature (EBT), blood eosinophils (Eos), and high sensitivity C-reactive protein (CRP). Before/after treatment differences between forced vital capacity percent of predicted (%FVC), a simple indicator of small airways involvement, were calculated and subjects were ranked accordingly to reflect the magnitude of the therapeutic response. Subjects above the 75th percentile (n = 15), “top responders”, were then compared with those below the 25th percentile (n = 15) “poor responders”. ResultsOn average, the 59 patients completing the study (mean age± SD 51 ± 12 years, 38 women) had significant improvement in VAS and QLQ scores at the end of the treatment period (49.1 ± 2.4 vs. 73.1 ± 2.05 and 146.1 ± 2.7 vs. 176.7.1 ± 3.4 respectively, P < 0.001), but not in the inflammatory indicators (EBT, CRP and Eos). However, when comparing the “top responders” with the “poor responders”, significant improvement in these inflammatory indicators was observed: EBT significantly decreased from 34.04/mean/± 0.30/s.e.m./[°C] to 33.57 ± 0.33, P = 0.003, Eos in blood fell from 381.7 ± 91.2 [cells/μL] to 244.2 ± 43.2, P = 0.02. Before/after treatment differences in hsCRP decreased significantly in the top responders compared with the poor responders (Mann–Whitney test, P = 0.04). ConclusionAsthmatic subjects who had the most improvement in FVC after transition to I-EF-BDP/F from other combined ICS/LABA preparations also demonstrated a significant decrease in some indicators of airway/systemic inflammation. These results support the notion that I-EF-BDP/F exerts an effect also at the level of the small airways through a reduction of the level of air trapping. Patients in whom inflammation of the small airways plays an important clinical role are the ones to derive most benefit from this small airways tailored treatment. However, improved compliance due to the “promise of a new drug” effect should also be considered as contributing to the treatment results.

Impact of Bronchodilator Responsiveness on Quality of Life and Exercise Capacity in Patients With COPD

Bronchial variability in COPD patients may be a phenotypic feature associated with clinical characteristics and differential treatment response. We analyzed whether symptoms, quality of life, and exercise capacity varied in COPD patients as a function of bronchodilator test results, and compared responses to an exercise program. A positive bronchodilator test result was defined as FVC and/or FEV1 improvement of > 12% plus > 200 mL after 400 μg of salbutamol. We studied 198 COPD subjects: 94 with positive reversibility, and 104 with negative reversibility. Training sessions were carried out on 3 non-consecutive days each week, for 12 weeks, and consisted of a combination of resistance and strength training. Subjects were evaluated on 2 consecutive days at baseline, and at the end of the 12-week training program. Those with positive reversibility had shorter time to exhaustion in the endurance test (19.1 ± 12.6 min vs 24.5 ± 14.5 min, P = .03), shorter shuttle walk test distance (380.6 ± 158.2 m vs 438.5 ± 149.1 m, P = .02), and lower Chronic Respiratory Disease Questionnaire scores (18.7 ± 4.6 vs 19.8 ± 4.3, P = .01). There were no significant differences in peak exercise, peripheral muscle strength, dyspnea, or improvement after exercise training. Compared to COPD subjects with negative reversibility, those with positive reversibility walked for shorter distances, and had shorter endurance times and worse quality of life, but the improvements after exercise training were similar.

AB0800 Safety and clinical response to rituximab in patients with connective tissue disease-associated interstitial lung disease: Preliminary results

BackgroundRituximab may benefit patients with connective tissue diseases (CTD).ObjectivesWe present here short-term safety and clinical outcomes of rituximab in CTD-associated interstitial lung disease (ILD) in a real-life clinical setting.MethodsAll patients...

SAT0198 Rituximab for the Treatment of Systemic Sclerosis Associated Interstitial Lung Disease: a Case Series

BackgroundRituximab (RTX) is a chimeric mAb against human CD20 that depletes peripheral B cells and introduced for systemic rheumatic diseases. Basic research and clinical studies have provided preliminary data pointing...

THU0245 Rituximab has a beneficial effect on lung function and skin fibrosis in patients with systemic sclerosis. An open label study

BackgroundEvidence suggests that B cells may play a role in fibrosis. We have previously shown that rituximab (RTX) may favorably affect lung function and skin fibrosis in patients with systemic...

Bronchial Responsiveness in Patients with Restrictive Spirometry

Background. Improvement in PFT after bronchodilators is characteristic of obstructive airway diseases such as COPD. However, improvement in patients with restrictive pattern is occasionally seen. We aim to determine the clinical significance of a bronchodilator responsive restrictive defect. Methods. Patients with restrictive spirometry and a bronchodilator study were identified at the University of Oklahoma and Oklahoma City VAMC between September 2003 and December 2009. Restriction was defined as a decreased FVC and FEV1, with normal FEV1/FVC. Responsiveness to bronchodilators was defined as an improvement in FEV1 and/or FVC of at least 12% and 200 mL. Patients with lung volume measurements had their clinical and radiographic records reviewed. Results. Twenty-one patients were included in the study. Most were current or ex-smokers, with most being on bronchodilators. The average FVC and FEV1 were 65 ± 11% and 62 ± 10% of the predicted, respectively. Most patients (66%) had a normal TLC, averaging 90 ± 16% of the predicted. RV, RV/TLC, and the TLC-VA values strongly suggested an obstructive defect. Conclusions. Reversible restrictive pattern on spirometry appears to be a variant of obstructive lung disease in which early airway closure results in air trapping and low FVC. In symptomatic patients, a therapeutic trial of bronchodilators may be beneficial.

Predictors for Identifying the Efficacy of Systemic Steroids on Sustained Exhaled Nitric Oxide Elevation in Severe Asthma

Some patients with asthma have high levels of exhaled nitric oxide fraction (FENO) despite inhaled corticosteroids (ICS) therapy. Early studies suggested that this might be explained by the presence of heterogeneous airway inflammation. We aimed to assess the predictors for identifying the efficacy of systemic corticosteroids on residual FENO elevations in severe asthma. Twenty severe asthmatics with persistent FENO elevation (≥40ppb) despite maintenance therapy including high-daily-dose ICS were enrolled. Asthma Control Questionnaire (ACQ), lung function, blood eosinophils, and FENO were assessed before and after 14 days treatment with 0.5mg/kg oral prednisolone/day. ACQ, blood eosinophils, FENO level, FVC, FEV1, FEV1/FVC ratio and the slope of the single nitrogen washout curve (ΔN2) were significantly improved by treatment with prednisolone. 70% of the subjects showed ≥20% reductions in the FENO levels. The reduction in FENO levels was significantly correlated with the improvements in ACQ (p < 0.0001), FVC (p < 0.01), FEV1 (p < 0.0001), and ΔN2 (p < 0.05). Among the measurements at baseline, the FENO levels and blood eosinophil numbers were identified as significant predictors of ≥20% reductions in the FENO levels by systemic steroid therapy. Systemic corticosteroids could suppress the residual FENO elevations in more than half of the patients with severe asthma and the reduction in FENO levels was associated with improvements in asthma control and airflow limitation. The FENO levels and blood eosinophil numbers were the predictors of improved residual airway inflammation by systemic steroid therapy in severe asthma.

EFFECT OF MACROLIDE ON LUNG FUNCTION AND COMPUTED TOMOGRAPHY (CT) SCORE IN NON-CYSTIC FIBROSIS BRONCHIECTASIS

Background: The few studies addressing the effect of macrolides in non-cystic fibrosis bronchiectasis (NCFB) range from no decline to significant improvement. There are no data evaluating macrolides on CT score.Objectives: To retrospectively evaluate the effect of initiation of macrolides on spirometry and HRCT in a NCFB population.Methods: We performed a word search in the electronic patient file data of the University Hospital of Leuven, Belgium, identifying all NCFB patients observed during a 41 month period and treated with macrolides. Records of all NCFB patients were manually reviewed, evaluating spirometry and CT scans, before and after/during macrolide treatment, treatment scheme, Pseudomonas status and other relevant data. CT scoring was done by using a modified version of the Brody score.Results: Evaluation of 131 patients showed a mean FEV1 improvement of 185 ml (p < 0.0001) or 7.7% (p < 0.0001) and a mean FVC improvement by 234 ml (p < 0.001) or 7.4% (p < 0.001). Smoking history, gender, Pseudomonas colonization and baseline lung function did not affect improvement in lung function. Patients with NCFB due to an immunodeficiency showed a significant larger macrolide-associated improvement in FEV1% (p = 0.0075) and FVC% (p = 0.0063) than patients with NCFB due to other causes. An improvement was noted in CT subscores for bronchiectasis (p = 0.0053), mucus plugging (p = 0.0256), peribronchial thickening (p = 0.0037), parenchyma (p = 0.026) and total modified Brody score (p = 0.001) after versus before macrolide therapy.Conclusion: Macrolides, as part of a multimodal and individualized therapy may significantly improve FVC, FEV1 and the modified Brody score in patients with NCFB, especially those with NCFB due to immunodeficiency.

Bronchodilation of umeclidinium, a new long-acting muscarinic antagonist, in COPD patients

BackgroundThis study evaluated the dose–response of the new long-acting muscarinic antagonist umeclidinium (GSK573719) in patients with COPD. MethodsThis randomized, double-blind, placebo-controlled, parallel-group study evaluated three once-daily doses of umeclidinium (125, 250 and 500μg) for 28days in 285 patients with COPD having FEV1 of 35–70% predicted (mean (SD) age=61.4 (8.41); mean (SD) post-bronchodilator FEV1=1.577 (0.450)). The primary endpoint was morning trough FEV1 at Day 29. Secondary endpoints included 0–6h weighted mean FEV1 and serial FEV1 measured over 6h post-dose and at trough. Safety and pharmacokinetics were also assessed. ResultsAll doses of umeclidinium significantly increased trough FEV1 over placebo from 150 to 168mL (p<0.001), 0–6h weighted mean FEV1 from 113 to 211mL (p<0.001), and serial FEV1 at each point in time over 24h. Reductions in salbutamol use and improvements in FVC were noted for all doses. Umeclidinium was well tolerated with no apparent treatment-related changes in vital signs. ConclusionOnce-daily umeclidinium provides clinically significant, sustained improvement in lung function and is well tolerated.

Bronchoscopic Lung Volume Reduction Coil Treatment of Patients With Severe Heterogeneous Emphysema

The lung volume reduction coil (LVR-coil), a new experimental device to achieve lung volume reduction by bronchoscopy in patients with severe emphysema, works in a manner unaffected by collateral airflow. We investigated the safety and efficacy of LVR-coil treatment in patients with heterogeneous emphysema. In this prospective cohort pilot study, patients were treated bronchoscopically with Nitinol LVR-coils under fluoroscopic guidance in either one procedure or two sequential procedures. Follow-up tests included the St. George Respiratory Questionnaire (SGRQ), pulmonary function testing, and the 6-min walk test (6MWT). Twenty-eight LVR-coil procedures were performed in 16 patients (baseline FEV₁, 28% [± 7.6%] predicted). Four patients were treated in one lung, and 12 patients were treated in both lungs. A median of 10 (5-12) coils was placed per lung in 36.5 (20-60) min. Adverse events (AEs) rated as possibly related to either the device or the procedure < 30 days after treatment were pneumothorax (n ± 1), pneumonia (n ± 2), COPD exacerbation (n ± 6), chest pain (n ± 4), and mild (< 5 mL) hemoptysis (n ± 21). From 30 days to 6 months, the AEs that occurred were pneumonia (n ± 3) and COPD exacerbation (n ± 14). All events resolved with standard care. Six months after LVR-coil treatment, there were significant improvements in SGRQ (-14.9 points [± 12.1 points, with 11 patients improving by > 4 points]), FEV₁ (+14.9% ± 17.0%), FVC (+13.4% ± 12.9%), residual volume (-11.4% ± 9.0%), and 6MWT (+84.4 ± 73.4 m), all P < .005. LVR-coil treatment is a promising technique for the treatment of patients with severe heterogeneous emphysema. The treatment is technically feasible and results in significant improvements in pulmonary function, exercise capacity, and quality of life, with an acceptable safety profile. ClinicalTrials.gov; No.:NCT01220908; URL: www.clinicaltrials.gov

A randomized, double-blind dose-ranging study of the novel LAMA GSK573719 in patients with COPD

This study evaluated the dose-response and dosing interval of the novel long-acting muscarinic receptor antagonist (LAMA) GSK573719 in patients with COPD. This randomized, double-blind, placebo-controlled, 3-way cross-over, incomplete block study evaluated 5 once-daily doses of GSK573719 (62.5-1000 μg), 3 twice-daily doses (62.5-250 μg), and open-label tiotropium for 14 days in patients (N = 176) with COPD (FEV(1) of 35-70% predicted). The primary endpoint was morning trough FEV(1) at Day 15. Secondary endpoints included 0-24 h weighted mean FEV(1) and serial FEV(1) values over 28 h. Safety measures and pharmacokinetics were assessed. All once-daily doses of GSK573719 significantly increased trough FEV(1) at Day 15 with improvements ranging from 95 to 186 mL over placebo (p ≤ 0.006), from 79 to 172 mL with twice-daily dosing (p ≤ 0.03), and 105 mL with tiotropium (p = 0.003). No clear dose ordering was observed. Once-daily doses significantly (p < 0.001) increased 0-24 h weighted mean FEV(1) at Day 14 by 131-143 mL over placebo, comparable to increases with the twice-daily doses (120-142 mL) and tiotropium (127 mL). Significant reductions in rescue albuterol use and improvements in FVC were also observed with once-daily dosing. Plasma C(max) occurred within 5-15 min of dosing after which the drug was rapidly cleared and eliminated. GSK573719 was well tolerated, with no apparent treatment-related changes in vital signs, ECG and Holter assessments, or clinical laboratory parameters. Once-daily dosing with GSK573719 in COPD provides clinically significant and sustained improvement in lung function over 24 h with similar efficacy to twice-daily dosing.

727 Negative Clinical Outcomes Associated with Postoperative Atrial Arrhythmias after Lung Transplantation

of valves. Two patients had pneumothorax. One patient had pneumonia associated with the valve placement and another had bronchial infection 2 months after treatment. All four patients required hospitalization for treatment. Conclusions: Treating NLH with IBV® Valve System leads to objective improvement in FEV1 and FVC in 36% and symptomatic and functional improvement in 50% of patients. Furthermore the treatment has an acceptable safety.

Changes in quality of life of patients with chronic obstructive pulmonary disease treated with high-frequency chest wall oscillations

Summary. Mechanical high-frequency vibration and compression of the chest wall using the VEST device (Hill-Rom, USA) could improve lung function and hyperinflation in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate quality of life of patients with COPD treated with the VEST device. This open comparative study was performed in a pneumology department of the municipal hospital № 57, Moscow. All the participants suffered from severe to very severe COPD (GOLD, 2006), or C to D stage COPD (GOLD, 2011) and received standard medication therapy. The 1st group (n = 11; mean age, 66.2 ± 7.0 years) was also treated with high-frequency chest wall oscillations. The 2st group (n = 12, mean age, 60.4 ± 8.6 years) received standard medication therapy only. As a result, the 1st group patients significantly improved FEV1, FVC and FEV1 / FVC with reduction in lung hyperinflation; the 2nd group showed improvement in FVC only. Quality of life of the COPD patients increased, primarily in the high-frequency chest wall oscillations group: physical activity improved by 13.2 % (p &lt; 0.001), a role of physical problems improved by 30.4 % (p &lt; 0.05), a role of emotional problems improved by 27.5 % (p &lt; 0.01), and well-being comparison improved by 9.15 % (p &lt; 0.05). Pain, vital force, general health and psychical health as criteria of quality of life also improved significantly. A strong correlation was found between quality of life and lung function parameters; reverse correlation was found between physical activity and MRC dyspnea score (r = –0.86). Therefore, high-frequency chest wall oscillations improved lung function and hyperinflation and quality of life, primarily in physical activity domain.

A comparative study of the effects of yoga and swimming on pulmonary functions in sedentary subjects

Context:The modality of exercise that is most beneficial and easy to perform has become a topic of research. Yogic exercises are being widely studied; however, postulated benefits of yogic exercises over other exercises must be scientifically explored. Prospective randomized comparative studies involving yoga and other endurance exercises are conspicuous by their absence.Aim:This study was, therefore, designed to assess and compare the effects of yogic training and swimming on pulmonary functions in normal healthy young volunteers.Materials and Methods:100 volunteers were inducted into the study and randomly divided into two groups: One group underwent 12 weeks training for yogic exercises and other for swimming. The training and data acquisition was done in small cohorts of 10 subjects each. The subjects were assessed by studying their anthropometric parameters and pulmonary function parameters (FVC, FEV1/FVC ratio, PEFR, FEF25-75%, FEF 0.2-1.2 l and MVV) both before and after training.Results:All parameters showed statistically significant improvements after both yoga and swimming. Comparison of these improvements for different parameters statistically analyzed by unpaired t test or Mann Whitney U test depicted a statistically better improvement in FVC, FEF25-75% and MVV with swimming as compared to yogic exercises.Conclusions:The output of this study gives slight edge to swimming as a preferred modality of exercise though either yoga or swimming can be advocated as an exercise prescription as both the modalities cause significant improvement of respiratory health. However, other factors like ability of any exercise regime to keep continued motivation and interest of the trainees must be taken into account for exercise prescription.