Including Breathing Exercises Research Articles

Evaluate the effectiveness of using non-pharmacological intervention during childbirth: an improvement project in Jordanian maternity hospitals.

Unnecessary childbirth interventions are still common in most hospitals in Jordan. Despite the recommendations from the WHO that unnecessary interventions during childbirth should be avoided, these interventions are still used. Non-pharmacological pain management interventions are considered a convenient alternative to unnecessary childbirth interventions because they can prevent unsafe side effects for mothers during childbirth. The study aims to determine the feasibility of non-pharmacological pain management interventions during childbirth and then to evaluate their influence on mothers' experience. Between May and June 2022, we implemented a quality improvement project with a bundle of non-pharmacologic comfort measures during childbirth. We started our project by (1) approaching all low-risk pregnant mothers who visited the hospital's antenatal clinic with a gestational age greater than 36 weeks. (2) Following the agreement, the researcher indicated that she would accompany the mother during the birthing process. (3) The researcher discussed different non-pharmacological pain management techniques and asked the mothers to choose how and when to utilize them. Non-pharmacological pain management techniques include breathing exercises, back massages, enabling mothers to move around, and providing modest amounts of water and soft food. (4) A few days after birth, the mother was interviewed one-to-one utilizing semi-structured audio-recorded interviews. The researcher interviewed eighteen postpartum mothers at a place of their choosing. Three main themes emerged from the interview analysis. The following themes were selected from the participants' own words: "Positive, respectful, and satisfying childbirth experience"; "Maintain mother's sense of control and cope with childbirth pain"; and "Birth outcome". These themes are connected and impacted by one another. Different research studies from diverse cultures recommend limiting the unnecessary use of interventions during childbirth and not interfering with childbirth unless medically necessary. Our participants expressed satisfaction with the use of culturally appropriate birth interventions during childbirth. These interventions were generally simple and safe, resulting in a satisfying birthing experience. The study findings contribute to achieving Sustainable Development Goal #3, "Good health and well-being" by reducing maternal and neonatal mortality, providing evidence of the effectiveness of non-pharmacological pain management, and avoiding unnecessary childbirth interventions.

EFFECTIVE APPROACHES TO ENHANCING CONNECTED SPEECH IN PREOPERATIVE CHILDREN WITH OPEN ORGANIC RHINOLALIA

Children with open organic rhinolalia, a condition often resulting from structural anomalies such as cleft palate, face unique challenges in speech development, particularly in the preoperative period. This article examines the methods, techniques, and strategies used to improve connected speech in these children before undergoing surgical intervention. Focusing on evidence-based practices, the article explores various speech therapy approaches, including breathing exercises, articulation drills, and resonance training, all tailored to address the specific needs of children with hypernasal speech. The goal of preoperative speech therapy is not only to prepare children for surgery but also to enhance their overall communication skills by developing more transparent and fluent speech. By reviewing current research and case studies, this article provides insights into effective treatment methods that can be applied in clinical settings to support children with open organic rhinolalia.

Lactation-focused audio relaxation versus standard care for mothers of very preterm infants (the EXPRESS randomised clinical trial).

Mothers of very premature newborns often have low milk supply. Systematic review has shown increased milk quantity with relaxation interventions. We hypothesised that a self-directed audio relaxation and lactation-specific visualisation would increase milk quantity after a very premature birth. Unmasked, randomised, controlled trial, recruiting 132 participants in four United Kingdom neonatal units. Eligible women had given birth to one or two infants between 23+0 and 31+6 weeks of gestation. The intervention was a 12-min voice recording including breathing exercises, muscle relaxation and lactation-specific visualisation. Primary outcome was the highest 24-h breastmilk weight expressed on any of day 4, day 14 or day 21 after birth. Mean birth gestation was 27.8 weeks (SD 2.4), with 26% of participants giving birth under 26 weeks (34/132). Adjusted mean difference in primary outcome was 73.9 g (95% CI -61.7 to 209.5, p = 0.28). Spielberger State-Trait Anxiety Index adjusted mean difference was -1.9 (-8.2 to 4.3, p = 0.54). The majority of relaxation group participants felt the intervention was relaxing (32/42, 76%). There was no beneficial effect of this relaxation intervention on milk quantity. Mothers of very premature infants may value relaxation interventions but they are unlikely to have a large effect on milk quantity. This randomised trial did not show a beneficial effect of a self-directed audio relaxation and visualisation on mothers' own milk quantity expressed after very preterm birth. Mothers of very and extremely preterm infants may value relaxation interventions, but they are unlikely to have a large effect on milk quantity. Prior systematic review of mixed populations has shown an increase in mothers' own milk quantity with relaxation interventions. Combining this study with existing meta-analysis could result in a new hypothesis that the lower the gestation at birth, the smaller the impact of relaxation on milk quantity.

The Importance of the Concentration of Selected Cytokines (IL-6, IL-10, IL-12, IL-15, TNF-α) and Inflammatory Markers (CRP, NLR, PLR, LMR, SII) in Predicting the Course of Rehabilitation for Patients after COVID-19 Infection.

In the course of COVID-19, there may be an excessive immune response of the body with the release of large amounts of pro-inflammatory cytokines, causing a "cytokine storm", also known as cytokine release syndrome (CRS). The COVID-19 pandemic has shown how important an integrated approach to health care is, with physiotherapy being one of its fundamental aspects. The aim of this study was to analyze the potential relationship between the level of selected cytokines (IL-6, IL-10, IL-12, IL-15, TNF-α) and inflammatory markers (CRP, NLR, PLR, LMR, SII) and the duration of rehabilitation in patients after COVID-19. The examined patients participated in a comprehensive rehabilitation program, which included breathing exercises, aerobic training, and strength and endurance training. Peripheral venous blood samples were also collected from each patient. Factors such as gender, smoking status, IL-10, and the presence of pneumonia during infection were significantly associated with the length of rehabilitation after COVID-19. The course of rehabilitation after COVID-19 may depend on many factors, including smoking, the presence of pneumonia due to infection, and some parameters of inflammation.

Rehabilitation Protocol for Children with Chest Tube for Pleural Effusion: A Quasi-Experimental Pre- and Post-test Study

Abstract Objective: The objective is to evaluate the effectiveness of a structured rehabilitation protocol on respiratory function and overall recovery in children with chest tubes for pleural effusion. Materials and Methods: A quasi-experimental pre-test and post-test design was employed. Thirty children aged 5–12 years with chest tubes for pleural effusion were enrolled. Participants were assessed before and after the intervention using pulmonary function tests (PFTs), physical activity levels and quality of life (QoL) surveys. The rehabilitation protocol included breathing exercises, physical therapy and educational sessions for patients and caregivers. Results: Significant improvements were observed in PFTs, physical activity levels and QoL scores post-intervention (P < 0.05). Conclusion: The structured rehabilitation protocol was effective in enhancing respiratory function and overall recovery in paediatric patients with chest tubes for pleural effusion.

Optimization of Lung Vital Capacity to Improve Athlete Fitness

Physical training and fitness are important aspects in an athlete's readiness to achieve optimal performance in their sport. One important indicator of fitness is vital lung capacity, which measures the maximum amount of air that can be moved into and out of the lungs. The aim of this study was to investigate the optimization of vital lung capacity as a strategy to improve athlete fitness. This study used qualitative research methods. The data collection technique in this research is literature study. The data that has been collected is then analyzed in three stages, namely data reduction, data presentation and drawing conclusions. The research results show that optimizing lung capacity to improve athlete fitness can be done through several methods, including breathing exercises, physical training and aerobic training. Increasing vital lung capacity can also help minimize the risk of injury, as a stronger respiratory system is able to prevent excessive fatigue. Overall, this can have a positive impact on athletes' achievements, both at national, regional and international levels, as well as representing the country, region or institution they are fighting for.

Safety and feasibility of pulmonary rehabilitation in patients hospitalized with post-COVID-19 fibrosis: A feasibility study.

Emerging data suggest a spectrum of pulmonary complications from COVID-19, ranging from dyspnea to difficult ventilator weaning and fibrotic lung damage. Prolonged hospitalization is known to significantly affect activity levels, impair muscle strength and reduce cardiopulmonary endurance. To assess the feasibility and safety of inpatient pulmonary rehabilitation (PR) and to explore effects on functional capacity, physical performance, fatigue levels, and functional status. A prospective feasibility study. Inpatient unit of a tertiary care hospital. Twenty-five hospitalized patients diagnosed with post-COVID-19 fibrosis referred for PR. Individualized PR intervention including breathing exercises, positioning, strengthening, functional training, and ambulation twice a day for 6 days a week. One-minute sit-to-stand test (STST), Short Physical Performance Battery (SPPB), Fatigue Assessment Scale (FAS), and Post-COVID-19 Functional Status Scale (PCFS). Twenty-five participants (19 males, 6 females) with a mean age of 54.2 ± 13.4 years were enrolled. Sixteen completed the two-point assessment after undergoing in-patient PR of mean duration 14.8 ± 9 days. PR led to a significant improvement in all functional outcomes that is, STST (from 7.1 ± 4.3 repetitions to 14.2 ± 2.1 repetitions, SPPB (from 5 ± 2.8 to 9.4 ± 1.5), FAS (from 33.3 ± 10.8 to 25.8 ± 4.7) at the p ≤ .001, and PCFS (from 3.6 ± 0.9 to 2.9 ± 1.2, p ≤ .05). Early initiation of PR for hospitalized patients with COVID-19 fibrosis was safe, well tolerated, and feasible and may improve functional status.

Peculiarities of physical therapy of chronic obstructive pulmonary disease: practical experience.

Aim: The aim of the study is todetermine the feasibility of using a home pulmonary rehabilitation program and evaluate its impact on patients with COPD in the GOLD B group. Materials and Methods: The study was conducted on the basis of the «Healthy Movements» studio (Poltava). Patients were involved in the study after receiving secondary (specialized) medical care, the basis of which was physical therapy treatment and exercise therapy in accordance with the clinical protocol approved by the internal order of the health care institution. A total of 30 people (aged 59 to 68.4 years) with II degree chronic obstructive pulmonary disease (50 % ≤ FEV1 < 80 % of normal) in remission took part in the study. Research methods: pedagogical, medical and biological , methods of mathematical statistics. Results: Each patient confirmed the achievement of the general goal, namely, increasing the number of therapeutic exercises from 3 to 5 times a week, improving the quality of life, more active participation in improving their health and awareness of the disease. The patients considered self-management training to be the most valuable. Conclusions: Pulmonary rehabilitation is indicated for all patients, regardless of the degree of the disease. The most ef f ective are 6-12 week programs that include breathing exercises, self-management training and training of the patient's environment, strengthening exercises, psychological support, diet therapy.

Effects of Respiratory Physiotherapy in Pulmonary Dysfunction after Cardiac Surgery

Background: Cardiovascular system diseases are a leading cause of death globally. Heart surgeries, performed worldwide to treat these conditions, are often followed by high rates of postoperative complications. Objective: The study aimed to compare the effects of pulmonary physiotherapy on respiratory dysfunction following cardiac surgery. Methods: Forty patients with pulmonary dysfunction post-coronary artery bypass grafting (CABG) participated in the study. They were randomly assigned to receive either postoperative pulmonary physical therapy, including breathing exercises and respiratory muscle training, or conventional physical therapy exercises. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and inspiratory capacity (IC) were measured using spirometry. Data analysis was conducted using the Statistical Package for the Social Sciences (SPSS), with paired t-tests comparing all variables. Results were considered significant at a p-value &lt; 0.05. Results: The study included 21 participants in each group, with a mean age of 55.37 ± 8.72 years. Mean vital capacity in Group A was 2.40 ± 0.46 pre-treatment, increasing to 2.97 ± 0.43, while in Group B it was 2.34 ± 0.41 at baseline, increasing to 2.98 ± 0.36, with a p-value &gt; 0.05 indicating no significant pre- and post-test effects in Group A. Significant pre-post differences in spirometry values were observed within both groups, but no significant differences were noted when compared across the groups following CABG. Conclusion: The study concluded that pulmonary rehabilitation post-cardiac surgery is highly recommended to minimize postoperative complications of heart surgery. It contributes significantly to the prognosis of these patients, emphasizing the importance of preoperative procedures focused on preventing pulmonary system complications and facilitating recovery in the postoperative period after major cardiac surgeries.

“A Safe Space for Sharing Feelings”: Perspectives of Children with Lived Experiences of Anxiety on Social Robots

Social robots have the potential to support health and quality of life for children experiencing anxiety. We engaged families with lived experiences of pediatric anxiety in social robot development to explore desired design features, application areas, and emotion functionalities of social robots in anxiety care. We conducted 10 online co-creation workshops with (1) children with anxiety aged 7–13 (n = 24) with their family members (n = 20), and (2) youth with anxiety aged 14–18 (n = 12). Workshop participation included a validated robot expectations scale, anonymous polls, and discussion. Transcripts and text responses were subjected to content analysis. A lived experience expert group provided feedback throughout the research. Participants desired a pet-like robot with a soft texture, expressive eyes, and emotion detection to support activities of daily living. Specific anxiety-related applications included breathing exercises, managing distressing thoughts, and encouragement. Emotional alignment, the design of a robot’s emotional display, and the emotional impacts of an interaction were discussed. Privacy and the replacement of human interaction were concerns. We identify pediatric anxiety-specific design features, applications, and affective considerations for existing and future social robots. Our findings highlight the need for customizability and robust emotional functionality in social robot technologies intended to support the health and care of children living with anxiety.

The Dhikr and Healthy aging in Indonesia: A Literature Review

Introduction: The increasing elderly population poses a unique challenge to countries, particularly in the field of healthcare. This study aims to identify evidence of the connection between dhikr and health among the elderly in Indonesia.&#x0D; Study Design: A literature review of research articles utilizing quantitative approaches, including observational and experimental studies. Article searches were conducted using data from PubMed, ProQuest, and Google Scholar, with publication limits set from 2013 to June 21, 2023. The research was conducted in Indonesia, and the participants were Indonesian Muslims aged 60 years or older.&#x0D; Results: A total of 25 articles were found through ProQuest, 115 through Google Scholar, and none through PubMed. Sixteen articles met the predetermined criteria, including one observational study and 15 experimental studies. Some researchers in the experimental studies combined dhikr with other interventions, including breathing exercises, ablution, and prayer. The phrases uttered during dhikr varied, including Surah Al-Fatihah, Astaghfirullah, Subhanallah, Alhamdulillah, La Ilaha Illallah, Allah Akbar, Ya Rahman, Ya Rahim, and blessings upon the Prophet.&#x0D; Conclusion: Dhikr has a positive impact on improving the health of the elderly, particularly in enhancing psychological well-being and reducing blood pressure.

An explanatory sequential pilot inquiry on music therapy and performance anxiety in university music education majors

Music Performance Anxiety (MPA) is prevalent among amateur and professional musicians. While music therapy has established itself as an effective therapy for reducing anxiety in numerous individuals with varying health issues, in depth research on the potential benefits of music therapy for managing MPA is lacking. This explanatory sequential pilot inquiry with 15 undergraduate music education majors from two large music faculties in Canada assessed the benefits of group music psychotherapy offered for 6 weeks in person or via telehealth on the experience of MPA. Test measures included the Spielberger State and Trait Anxiety Inventories (STAI) pre and post study, a pre and post study questionnaire, pre and post music psychotherapy session Likert scales for anxiety and mood, and a post study interview. Music psychotherapy interventions included breathing exercises, grounding and guided visualizations/meditations, and musical improvisation. Quantitative data, assessed for all participants combined and by group, revealed that anxiety and mood scores on the Likert scale improved after participation in six music psychotherapy sessions, while the STAI scores remained constant pre and post study. Qualitative themes suggest the benefits of music psychotherapy for changed perception and cognitions, sense of support, reduction in symptoms and overall continued and future management of MPA. The results of this study are promising, pointing to music psychotherapy as a potential short-term therapy for MPA symptom management, having practical implications for post-secondary music education and future research.

Eficacia de las intervenciones fisioterápicas sobre la musculatura respiratoria mediante técnicas de entrenamiento respiratorio en el postoperatorio de trasplantados pulmonares: una revisión sistemática

IntroductionRespiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period. Material and methodsA systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: “breathing exercise”, “respiratory muscle training”, “inspiratory muscle training”, “respiratory exercise”, “pulmonary rehabilitation”, “lung rehabilitation”; in combination with “lung transplantation”, “lung transplant”, “posttransplant lung”. No language limit. ResultsEleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test. ConclusionsTraining the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.

The Impact of Comprehensive Rehabilitation on the Exercise Capacity of Patients after COVID-19.

Coronavirus Disease 2019 (COVID-19) is a complex disease that affects multiple body systems, including the respiratory, cardiovascular, neurological, and muscular systems. It is estimated that approximately half of the patients after the treatment for COVID-19 experience persistent symptoms that lead to a decreased physical capacity. Scientific recommendations suggest that cardiovascular and respiratory rehabilitation programs should be implemented in patients who have completed treatment for COVID-19. Therefore, the objective of this study was to evaluate the impact of comprehensive rehabilitation on the exercise capacity of patients after COVID-19 treatment. The study included 146 patients after the treatment for COVID-19 who were eligible for therapeutic rehabilitation. The exercise capacity was assessed using the 6-minute walk test (6MWT). The results showed that patients who underwent rehabilitation had an average increase of 23.83% in their 6MWT score compared to the baseline. A comprehensive rehabilitation program including breathing exercises, aerobic training, and strength and endurance exercises is an effective intervention that can improve the physical capacity of patients after COVID-19 treatment.

Pengenalan Modalitas Fisioterapi Untuk Penanganan Hipertensi Pada Lansia Di Desa Gatak

Hypertension is a condition in which abnormally increased blood pressure in the arterial vessels secra continuously for more than one period, according to the WHO, a person is said to have hypertension when the blood pressure reaches &gt;160/95 mmHg and is considered normal. Hypertension can be influenced by lifestyle and diet. There are many ways to cope with hypertension such as a healthy lifestyle and routine health checks to control blood pressure. Another way to deal with hypertension in the elderly is to use physiotherapy modalities, including breathing exercises to help lower blood pressure and fast walking exertions that work through reduced peripheral resistance.

Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review.

Pulmonary rehabilitation is a vital component of comprehensive care for patients with respiratory conditions, such as lung cancer, chronic obstructive pulmonary disease, and asthma, and those recovering from respiratory diseases like COVID-19. It aims to enhance patients' functional ability and quality of life, and reduce symptoms, such as stress, anxiety, and chronic pain. Virtual reality is a novel technology that offers new opportunities for customized implementation and self-control of pulmonary rehabilitation through patient engagement. This review focused on all types of virtual reality technologies (nonimmersive, semi-immersive, and fully immersive) that witnessed significant development and were released in the field of pulmonary rehabilitation, including breathing exercises, biofeedback systems, virtual environments for exercise, and educational models. The review screened 7 electronic libraries from 2010 to 2023. The libraries were ACM Digital Library, Google Scholar, IEEE Xplore, MEDLINE, PubMed, Sage, and ScienceDirect. Thematic analysis was used as an additional methodology to classify our findings based on themes. The themes were virtual reality training, interaction, types of virtual environments, effectiveness, feasibility, design strategies, limitations, and future directions. A total of 2319 articles were identified, and after a detailed screening process, 32 studies were reviewed. Based on the findings of all the studies that were reviewed (29 with a positive label and 3 with a neutral label), virtual reality can be an effective solution for pulmonary rehabilitation in patients with lung cancer, chronic obstructive pulmonary disease, and asthma, and in individuals and children who are dealing with mental health-related disorders, such as anxiety. The outcomes indicated that virtual reality is a reliable and feasible solution for pulmonary rehabilitation. Interventions can provide immersive experiences to patients and offer tailored and engaging rehabilitation that promotes improved functional outcomes of pulmonary rehabilitation, breathing body awareness, and relaxation breathing techniques. The identified studies on virtual reality in pulmonary rehabilitation showed that virtual reality holds great promise for improving the outcomes and experiences of patients. The immersive and interactive nature of virtual reality interventions offers a new dimension to traditional rehabilitation approaches, providing personalized exercises and addressing psychological well-being. However, additional research is needed to establish standardized protocols, identify the most effective strategies, and evaluate long-term benefits. As virtual reality technology continues to advance, it has the potential to revolutionize pulmonary rehabilitation and significantly improve the lives of patients with chronic lung diseases.

Combined Effects of Continuous Positive Airway Pressure and Cycle Ergometer in Early Rehabilitation of Coronary Artery Bypass Surgery Patients.

To determine the combined effects of continuous positive airway pressure (C-PAP) and physical exercise rehabilitation on a cycle ergometer on postcoronary artery bypass surgery patients. Randomised controlled trial. Place and Duration of the Study: Rawalpindi Institute of Cardiology, from December 2020 to May 2021. Patients, who underwent coronary artery bypass graft surgery, were divided into two equal groups of each 51. The control group received standard physiotherapy from the 1st postoperative day which included breathing exercises, passive mobilisation in the sitting position, and ambulation. The interventional group also had standard physiotherapy from 1st postoperative day; but also the 2nd to 4th postoperative day had additional dynamic exercises on cycle ergometry in combination with CPAP (continuous positive airway pressure). There was a significant improvement in functional capacity measured by 6-minute walk test in the interventional group (p<0.001). Length of hospital and ICU stay mean rank (68.88 and 58) were also significantly decreased in the interventional group (p<0.001). There was no improvement in maximum inspiratory pressure and maximum expiratory pressure. One-minute sit-to-stand test was increased on 4th postoperative day in the interventional group. There was no significant difference observed in arterial blood gases between these two groups. Cycle ergometry combined with continuous positive airway pressure (C-PAP) applied earlier on patients undergoing coronary artery bypass grafting improves the functional capacity, decreases the ICU and hospital length of stay and also improves lower limb muscle strength. But no difference in respiratory muscle strength and arterial blood gases was observed between the control and interventional groups. Aerobic exercise, Coronary artery bypass graft surgery, Continuous positive airway pressure.

The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: a systematic review and meta-analysis

BackgroundThe main aim of this systematic review was to determine the effectiveness of postoperative rehabilitation interventions that include breathing exercises as a component to prevent atelectasis in lung cancer resection patients.MethodsIn this review, we systematically and comprehensively searched the Cochrane Library, PubMed, EMBASE, and Web of Science in English and CNKI and Wanfang in Chinese from 2012 to 2022. The review included any randomized controlled trials focusing on the effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer patients. Participants who underwent anatomic pulmonary resection and received postoperative rehabilitation interventions that included breathing exercises as a component were included in this review. The study quality and risks of bias were measured with the GRADE and Cochrane Collaboration tools, and statistical analysis was performed utilizing RevMan 5.3 software.ResultsThe incidence of atelectasis was significantly lower in the postoperative rehabilitation intervention group (OR = 0.35; 95% CI, 0.18 to 0.67; I2 = 0%; P = 0.67) than in the control group. The patients who underwent the postoperative rehabilitation program that included breathing exercises (intervention group) had higher forced vital capacity (FVC) scores (MD = 0.24; 95% CI, 0.07 to 0.41; I2 = 73%; P = 0.02), forced expiratory volume in one second (FEV1) scores (MD = 0.31; 95% CI, 0.03 to 0.60; I2 = 98%; P < 0.01) and FEV1/FVC ratios (MD = 9.09; 95% CI, 1.50 to 16.67; I2 = 94%; P < 0.01).ConclusionPostoperative rehabilitation interventions that included breathing exercises decreased the incidence rate of atelectasis and improved lung function by increasing the FVC, FEV1, and FEV1/FVC ratio.

A toolbox for a structured risk-based prehabilitation program in major surgical oncology.

Prehabilitation is a multimodal concept to improve functional capability prior to surgery, so that the patients' resilience is strengthened to withstand any peri- and postoperative comorbidity. It covers physical activities, nutrition, and psychosocial wellbeing. The literature is heterogeneous in outcomes and definitions. In this scoping review, class 1 and 2 evidence was included to identify seven main aspects of prehabilitation for the treatment pathway: (i) risk assessment, (ii) FITT (frequency, interventions, time, type of exercise) principles of prehabilitation exercise, (iii) outcome measures, (iv) nutrition, (v) patient blood management, (vi) mental wellbeing, and (vii) economic potential. Recommendations include the risk of tumor progression due to delay of surgery. Patients undergoing prehabilitation should perceive risk assessment by structured, quantifiable, and validated tools like Risk Analysis Index, Charlson Comorbidity Index (CCI), American Society of Anesthesiology Score, or Eastern Co-operative Oncology Group scoring. Assessments should be repeated to quantify its effects. The most common types of exercise include breathing exercises and moderate- to high-intensity interval protocols. The program should have a duration of 3-6 weeks with 3-4 exercises per week that take 30-60 min. The 6-Minute Walking Testing is a valid and resource-saving tool to assess changes in aerobic capacity. Long-term assessment should include standardized outcome measurements (overall survival, 90-day survival, Dindo-Clavien/CCI®) to monitor the potential of up to 50% less morbidity. Finally, individual cost-revenue assessment can help assess health economics, confirming the hypothetic saving of $8 for treatment for $1 spent for prehabilitation. These recommendations should serve as a toolbox to generate hypotheses, discussion, and systematic approaches to develop clinical prehabilitation standards.

Effects of An Individualized Pulmonary Rehabilitation Program in Post-COVID Fibrosis: A Case Report

Long COVID-19 Syndrome, in addition to symptoms such as chronic cough, exertional dyspnea and fatigue, pulmonary fibrosis is presented as specific respiratory system problems. Post-COVID fibrosis is characterized by radiographic abnormalities consistent with pulmonary fibrosis. Patients with post-COVID fibrosis may benefit from pulmonary rehabilitation programs. This case report aimed to investigate the effects of an individualized pulmonary rehabilitation (PR) program on selected clinical parameters in a 46-year-old male who was diagnosed with post-COVID fibrosis. Spirometry and diffusion tests were investigated. Six-minute walk and shuttle walk tests for exercise capacity, hand-held dynamometer for quadriceps muscle strength, mMrc dyspnea scale for dyspnea, Fatigue Severity Scale for fatigue and London Chest Activity of Daily Living for activities of daily living were evaluated. An individualized PR program included breathing exercises, single-leg cycle training (for the right leg, 10 to 30 min) and bilateral neuromuscular electrical stimulation for quadriceps muscles (30 min) was prescribed 3 days a week for 8 weeks. Small but promising improvements were observed in FEV1, FVC, FEV1/FVC, DLCO, 6MWD, shuttle walk tests walking distance and time, quadriceps muscle strength, mMRC and FSS scores. PR program combined with antifibrotic therapy has the potential to improve respiratory functions, exercise capacity, muscle strength, dyspnea, fatigue, and participation in ADL in patient with post-COVID fibrosis.