Modified Borg Scale Research Articles

Investigation of immunosuppressive treatment compliance, dyspnea, anxiety, and depression levels in lung transplant recipients: online interview.

Following lung transplantation (LTx), it is important for recipients to comply with immunosuppressive treatment and cope with related problems. In the post-LTx period, the course of dyspnea and psychological problems it causes in case of progression are not known. Depression and anxiety may develop in recipients after LTx. However, the relationship between this situation and treatment compliance and dyspnea is uncertain. The aim of this study was to investigate dyspnea, anxiety, and depression levels of recipients following LTx and their immunosuppressive treatment compliance. The study was planned as a descriptive, correlational, and cross-sectional study. Data were collected on various social media platforms via an online interview, and 65 LTx recipients were included in the sample (n = 65). A Participant Information Form, the Modified Borg Scale, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Immunosuppressive Drug Compliance Scale were employed to collect data. The collected data were analyzed using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test. The mean age of the participants was found to be 52.60 ± 9.44 years, and 56.9% were male. Forty percent of the participants were dependent on oxygen support, and 32.2% had hypertension. Their dyspnea levels were mild, anxiety levels were moderate, depression levels were high, and immunosuppressive treatment compliance levels were slightly above-average. According to the correlation analysis results, dyspnea was associated with anxiety and depression (p < 0.05). As depression increased, immunosuppressive treatment compliance decreased, and the correlation between the two variables was statistically significant (p < 0.05). In this study, as the severity of dyspnea experienced by LTRs increased, the severity of their anxiety and depression also increased. Additionally, there was an inverse correlation between depression and immunosuppressive treatment compliance. LTRs demonstrated insufficient adherence to their immunosuppressive drug regimens, which is very significant in terms of graft survivability. These results suggest that LTRs should be closely monitored at home.

Safety and efficacy of oxycodone for refractory dyspnea in end-stage heart failure patients with chronic kidney disease: a case series of eight patients

BackgroundMorphine is effective in palliative care for patients with end-stage heart failure; however, its use is avoided in patients with impaired renal function because it tends to induce adverse effects. Although oxycodone has been reported to be a useful alternative, the evidence is insufficient. Therefore, we investigated the safety and efficacy of oxycodone in eight patients with end-stage heart failure complicated by chronic kidney disease. MethodsThis single-center retrospective study reviewed patients with end-stage heart failure who were referred to the heart failure multidisciplinary team at our institution and administered oxycodone for refractory dyspnea during hospitalization between January 2011 and December 2018. We examined the details of oxycodone usage, vital signs, and the Modified Borg Scale (MBS), which quantifies the symptoms of dyspnea and adverse events.ResultsOxycodone was administered for refractory dyspnea in eight patients with end-stage heart failure [mean age: 81 years, men: 4, New York Heart Association functional class IV: 8, median left ventricular ejection fraction: < 40% (n = 6) and ≥ 50% (n = 2)]. Renal function was reduced in all patients; the estimated glomerular filtration rate (eGFR) in seven patients was < 30 mL/min/1.73 m2. The median initial intravenous dose of oxycodone was 7.05 mg/day (range: 5–10 mg/day), and the average duration of administration was 15.8 days. Significant decreases in MBS (before: median 9, range 7–10 vs. after: median 2.5, range 1–8; p < 0.01) were observed at a median of 2.0 days (range: 2 h to 7 days) after beginning oxycodone administration. Systolic blood pressure, heart rate, and respiratory rate were not significantly altered after treatment. Adverse events, including constipation, nausea, and tremors, were observed in three patients. However, no lethal adverse events related to oxycodone treatment occurred during treatment.ConclusionsThis study revealed the clinical practice of oxycodone treatment and suggested that it is an alternative therapy as a viable palliative for refractory dyspnea in patients with end-stage heart failure who should avoid the use of morphine.

The 1-minute sit-to-stand test to evaluate fibrotic interstitial lung disease

IntroductionFibrotic interstitial lung diseases (ILD) are a heterogeneous group of conditions. Progression criteria include clinical, imaging, and/or lung functional decline. Currently, the 6-minute walk test (6MWT) is considered the gold standard for assessing exercise-induced desaturation. The 1-minute sit-to-stand test (1STST) has the advantage of being easy to perform, making it feasible for use during clinical consultations. The aim of this study was to compare the 1STST with the 6MWT in patients with fibrotic ILD to detect exercise-induced desaturation. MethodsA multicenter cross-sectional involved patients with fibrotic ILDs from two centers. The 6MWT and 1STST were performed with a 30-minute rest period between the tests. The modified Borg scale was used to assess dyspnea and lower limb fatigue and continuous SpO2 and heart rate were monitored. Desaturation was defined as SpO2 < 90% or decline >3%. ResultsNinety patients were included. The median walking distance in the 6MWT was 432 meters and the median number of repetitions in the 1STST was 22, with a significant correlation (p<0.001, ρ=0.383). In addition, the minimum SpO2 and the desaturation levels recorded during the tests exhibited a moderate significant correlation (p<0.001, ρ=0.502 and p<0.001, ρ=0.537, respectively). There was a strong association between the increase in Borg score for dyspnea and a moderate association between the increase in Borg score for lower limb fatigue after both tests (p<0.001, ρ=0.706 and p<0.001, ρ=0.656, respectively). ConclusionsThis study demonstrates a significant correlation between the 6MWT and the 1STST in detecting exercise-induced desaturation.

Validity and reliability of an immersive virtual reality adaptation of the 6-minute pegboard and ring test

Background and AimVirtual reality offers new clinical assessment and rehabilitation options that can complement or, in some cases, replace traditional methods. However, the applicability of using virtual reality tools for assessment of upper limb functional capacity has not been fully explored. We therefore developed an immersive virtual reality adaptation of the 6-Minute Pegboard and Ring Test (6PBRT-VR). The aim of the study was to test the validity and reliability of the 6PBRT-VR for the assessment of upper extremity functional capacity, and to assess the performance and feasibility of the proposed tool. MethodsThirty healthy young adults were included in the study. The participants performed the classical 6-Minute Pegboard and Ring Test first and then the 6PBRT-VR. The test-retest reliability of the 6PBRT-VR was assessed on intraclass correlation coefficient. Concurrent validity was assessed on the correlation between the 6PBRT-VR test-retest scores (number of rings moved) and the correlation between the scores from the classical 6-Minute Pegboard and Ring Test and the 6PBRT-VR. Convergent validity was assessed on correlations with handgrip strength and the total Quick Disabilities of the Arm, Shoulder, and Hand score. Cardiorespiratory responses were also measured (at baseline and after each test). Perceived arm fatigue was assessed on the Modified Borg Scale. ResultsThe 6PBRT-VR exhibited excellent test-retest reliability, with an intraclass correlation coefficient of 0.866 (95% confidence interval 0.737−0.934). Mean 6PBRT-VR score correlated strongly with the mean score of the classical 6-Minute Pegboard and Ring Test (r = 0.817, p < 0.001). A significant association was found between the 6PBRT-VR and the classical 6-Minute Pegboard and Ring Test in terms of variations in heart rate, systolic blood pressure, and Modified Borg Scale score (p < 0.001). Mean 6PBRT-VR score showed moderate correlations with right (r = 0.571, p = 0.001) and left handgrip strength (r = 0.550, p = 0.002). ConclusionThe 6PBRT-VR is a reliable and valid virtual tool for assessing upper-extremity functional capacity in young adults.

Classification of Patients Based on Dyspnea and Desaturation During Exercise in Interstitial Lung Disease.

Dyspnea and desaturation during exercise are essential assessment items for pulmonary rehabilitation. Characterizing patients using these 2 factors may be important for providing more effective pulmonary rehabilitation. This study aimed to categorize subjects with interstitial lung disease (ILD) using dyspnea and desaturation at the end of the 6-min walk test (6MWT). This was a retrospective study including 230 stable subjects with ILD who underwent 6MWT in our out-patient department at a general hospital in Japan. The modified Borg scale and oxygen saturation determined by SpO2 at the end of the 6MWT were used for cluster analysis using the k-means method with k = 4. Subjects were classified into 4 characteristic clusters. SpO2 at the end of the 6MWT was lower in cluster 4 (80.5 ± 3.0%) than in clusters 1 (94.3 ± 2.0%), 2 (94.3 ± 1.9%), and 3 (87.9 ± 1.8%) and was lower in cluster 3 than in clusters 1 and 2. The modified Borg scale score at the end of the 6MWT was higher in clusters 2 (4 [3-8]), 3 (3 [0-9]), and 4 (4 [0-7]) than in cluster 1 (0.5 [0-2.0]) and was higher in cluster 2 than in cluster 3. Subjects with ILD were classified into 4 characteristic clusters using dyspnea and SpO2 at the end of the 6MWT. The 4 clusters are characterized as follows: Cluster 1 had mild desaturation and mild dyspnea; cluster 2 had mild desaturation and severe dyspnea; cluster 3 had both moderate desaturation and dyspnea, and cluster 4 had both severe desaturation and dyspnea. These classification data offer insight for individualized pulmonary rehabilitation for patients with ILD.

Fisioterapia pulmonar pós-COVID-19: um estudo de caso

The COVID-19 pandemic emerged in Wuhan in late December 2019, spreading across the world with a high rate of contamination. The COVID-19 covers a large number of sequelae in the respiratory system, which entails a need for intense physiotherapy intervention. Thus, it was objected in the present study to evaluate the effectiveness of post-COVID-19 pulmonary physiotherapy in a patient at a Physiotherapy Clinic School in the city of Montes Claros, MG. For this, it was used the case study as a methodology, which was carried out with a male patient, 62 years old, brown, divorced, with one child, with no report of previous illnesses, coming from the city of Montes Azul-MG, admitted in a Physiotherapy Clinic School with Severe Acute Respiratory Syndrome, post-COVID-19, being submitted to tests to assess their perceptions of exertion through the modified Borg scale, that is, the Six-Minute Walking Test and the muscle strength based on the Kendall scale. In view of the conduct performed, it is concluded that physiotherapy rehabilitation is an important resource in post-Covid-19 treatment, with regard to the proportion of sequelae caused by such infection.

Effects of home-based telerehabilitation-assisted inspiratory muscle training in patients with idiopathic pulmonary fibrosis: A randomized controlled trial.

There are few studies that have used inspiratory muscle training (IMT) as an intervention for patients with isolated idiopathic pulmonary fibrosis (IPF). This study aimed to investigate and interpret the effects of home-based telerehabilitation-assisted IMT in patients with IPF. Twenty-eight participants with IPF took part in the study. Lung function tests, functional exercise capacity by 6-min walk distance (6MWD), dyspnoea perception by modified medical research council dyspnoea scale (mMRC), and inspiratory muscle strength by maximal inspiratory pressure (MIP) were assessed. IMT was performed twice a day, 7 days/week, for 8 weeks. The intervention group (n = 14) performed IMT at 50% of their baseline MIP while the control group (n = 14) performed IMT without applied resistance. Loading intensity was progressed by keeping the load at 4-6 on a modified Borg scale for the highest tolerable perceived respiratory effort for each patient. Dyspnoea based on mMRC score (p < 0.001, η2 effect size = 0.48) significantly decreased within the intervention group compared with the control group. There were significant increases in the intervention group compared to the control group based on 6MWD (p < 0.001, η2 effect size = 0.43), MIP (p = 0.006, η2 effect size = 0.25) and MIP % predicted (p = 0.008, η2 effect size = 0.25). The findings of this study suggest that an 8-week home-based telerehabilitation-assisted IMT intervention produced improvements in inspiratory muscle strength, leading to improvements in functional exercise capacity and dyspnoea.

Effects of cardiopulmonary rehabilitation on lung and respiratory muscle function of patients with post-COVID-19 syndrome: a controlled and randomized study

Purpose: Thus, this study aimed to evaluate the effects of cardiopulmonary rehabilitation on lung and respiratory muscle function of patients with post-COVID-19 syndrome. Patients and methods: We conducted a randomized controlled trial with 34 patients with post-COVID-19 syndrome (&gt; 18 years) who were symptomatic for more than four weeks. The evaluators were blinded. Participants were randomized into two groups: cardiopulmonary rehabilitation group or biweekly lectures (control group) regarding health education. We assessed lung function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], FEV1/FVC ratio, and peak expiratory flow [PEF]), respiratory muscle strength and endurance, diaphragmatic thickening fraction and mobility, and dyspnea (modified Borg scale). Results: The intervention improved FVC, FEV1, and PEF of patients after six weeks of rehabilitation. The rehabilitation group also showed lower dyspnea and respiratory muscle strength and endurance than the control group. Conclusion: The cardiopulmonary rehabilitation protocol improved lung and respiratory muscle function and reduced dyspnea in patients with post-COVID-19 syndrome.

Breath assessment at with post-tuberculosis patients suffered new coronavirus infection

BACKGROUND: The possibility of mutual aggravation of post-tuberculosis and post-COVID respiratory pathologies requires additional consideration. AIM: To study some subjective breathing parameters at patients with post-tuberculosis pulmonary residual changes after a new coronavirus infection recovering. MATERIALS AND METHODS: The study included two groups: the main group — 14 patients with cured pulmonary tuberculosis, who had recovered from a new coronavirus infection, a comparison group — 52 patients with post-tuberculosis changes non-sick new coronavirus infection who were admitted to the tuberculosis sanatorium “Glukhovskaya” in 2020–2021. The severity of shortness of breath using the Modified Medical Research Council (mMRC) and Borg scales was assessed upon admission to the sanatorium and a month later. Results: The mMRC scale was 1.5 ± 1.4 and 2.1 ± 0.2 and the Borg scale was 1.5 ± 1.4 and 2.9 ± 0.2 before treatment respectively in the main group and the comparison group. According to the mMRC scale initially 14.3 and 11.5% of patients with pulmonary tuberculosis and the comparison group did not complain of shortness of breath and 50% of pulmonary tuberculosis patients and 42.4% of the comparison group defined it as severe. After a month there were 3 or 4 points on the mMRC scale among pulmonary tuberculosis patients. In the comparison group 3-point shortness of breath decreased by 11.2 times most often indicated shortness of breath with 2 score. According to the Borg scale dyspnea was initially assessed as 3 points at 71.5% pulmonary tuberculosis patients. In the comparison group 67.3% patients had grade 3 dyspnea and 11.5% noted 4–6 grade shortness of breath. After a month the proportion of patients with mild shortness of breath at the pulmonary tuberculosis and comparison groups increased by 4.5 and 3.3 times, respectively, and the frequency of 3-grade shortness of breath decreased by 5 and 3.9 times. CONCLUSIONS: Major post-tuberculosis changes, smoking and chronic obstructive pulmonary disease determine the severity of breathing discomfort to a greater extent than the experience of new coronavirus infection but rehabilitation treatment are leveled out these differences. It is advisable to study the state of the respiratory system at patients cured of pulmonary tuberculosis.

The Effect of Assistive Robotic Technologies on Quality of Life and Functional Independence in Individuals with Spinal Cord Injury

Purpose: To investigate the effect of assistive robotic technologies on quality of life, functional independence, and perceived fatigue level during exertion in individuals with spinal cord injury. Method: This research involved a cohort of 25 patients who had been diagnosed with spinal cord injury (SCI). To assess their progress, clinical assessments were administered both at the commencement and completion of a six-week treatment regimen. The evaluations encompassed the use of the Spinal Cord Independence Measure (SCIM III) to measure their performance in daily living activities and mobility. Additionally, the quality of life was assessed using the World Health Organization Quality of Life Scale – Short Form (WHOQOL-BREF) scale, while the levels of fatigue experienced during rehabilitation were gauged using the Modified Borg Scale (RPE). Results: The participants' average age and BMI were 40.72±1.28 and 23.43±0.57. Statistically significant differences were found in self-care (p=0.006) and mobility (p=0.004) values of SCIM III scale compared to pretreatment values. WHOQOL-BREF General health status, Physical health, Psychological, Social relations and Environment sub-parameters all showed statistically significant differences compared to pre-treatment values (p=0.001). There was a significant decrease in the RPE value to determine the level of fatigue during exertion in robotic walking training (p

Comparing the Effect of Pursed Lip Breathing and Diaphragmatic Breathing on Pulmonary Function and Exercise Frequency in COPD Patients

Background: COPD is a disease having both pulmonary and extra-pulmonary consequences , a curable but avoidable condition that frequently results in serious difficulties for patients. Its hallmark is a progressive and permanent limiting of airflow brought on by long-term lung inflammation brought on by a variety of dangerous particles or gases. The GOLD strategy highlights the importance of a post-bronchodilator FEV1/FVC ratio &lt; 0.7 and stresses spirometry as the cornerstone for diagnosis. With the help of this criteria-driven method, COPD can be accurately identified and managed in accordance with medical recommendations. Objectives: The aim of study was to investigate the effect of pursed lip breathing exercise and effect of diaphragmatic breathing in COPD patients and also to check improvement of pulmonary function and exercise frequency. Methods: The study was Quasi experimental in which purposive sampling technique was done from COPD patients from DHQ and General hospital, Faisalabad after meeting inclusion criteria. The study duration was 6 months.Forty individuals with COPD wasdivided into two groups: group 1 and group 2. Group 1 received pursed lip breathing exercise and group 2 receiveddiaphragmatic breathing exercise for 8 weeks. To check the normality of data distribution shiparo wilk test was applied. FVC and FEV1 by FVC at baseline shows p values more than 0.05. Data was normally distributed so parametric tests were applied. Paired sample T test for comparison within group which shows p values less than 0.05. Independent sample T Test for comparison between groups which shows p values greater than 0.05. Evaluation of exercise frequency and pulmonary function was measured by counting the number of exercises performed, modifiedborg scale and spirometry (FVC,FEV1, FEV1/FVC) Data was analyzed by SPSS version 24 for this study. Results: there was no significant difference between the effects of pursed lip breathing and diaphragmatic breathing exercises on pulmonary function and exercise frequency. Conclusion: Both interventions were equally effective. Keywords: Pulmonary, Obstructive, Breathing Exercise, Tolerance, Rehabilitation, Respiratory mechanics.

Clinical efficacy and safety of the self-developed Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a significant global public health issue. Modern medical treatments have both benefits and limitations, prompting increasing attention from scholars worldwide on traditional ethnic medicine, and the Zangsiwei Qingfei Mixture is a newly developed formula derived from the effective components of classical Tibetan medicine to treat chronic respiratory diseases. This study aims to investigate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Sixty AECOPD patients admitted to the Second Xiangya Hospital of Central South University from May 2021 to May 2023 were enrolled and randomly divided into 2 groups, with 30 patients in each group. The control group received conventional treatment, including bronchodilators, anti-infection agents, expectorants, and oxygen therapy. The experimental group received the Zangsiwei Qingfei Mixture in addition to conventional treatment. The treatment duration was 7 d for both groups. Baseline data such as gender, age, body mass index (BMI), smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, COPD course, and the number of COPD exacerbations in the past year were collected. The primary efficacy indicators were assessed using the modified Medical Research Council (mMRC) dyspnea scale and the modified Borg scale. Secondary indicators included arterial lactic acid (LAC) and serum tumor necrosis factor alpha (TNF-α) levels. Safety indicators included liver and kidney function [alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (SCr), serum uric acid (SUA)], coagulation function [activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), and D-dimer]. The generalized linear mixed model (GLMM) was used to evaluate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture. Before treatment, there were no statistically significant differences in general baseline data, grading of mMRC dyspnea scale, score of modified Borg scale, arterial LAC, ALT, AST, SCr, SUA, APTT, FIB, and D-dimer between the 2 groups (all P>0.05). However, serum TNF-α and PT levels in the experimental group were significantly lower than those in the control group (both P<0.05). GLMM analysis showed that after adjusting for pre- and post-treatment, gender, age, BMI, smoking status, GOLD classification, COPD course, and the number of COPD exacerbations in the past year, the experimental group demonstrated significantly lower grading of mMRC dyspnea scale (coefficient=-0.329, P=0.036), score of modified Borg scale (coefficient=-1.077, P=0.001), serum TNF-α level (coefficient=-14.378, P<0.001), and arterial LAC level (coefficient=-0.409, P=0.012) compared to the control group. The Zangsiwei Qingfei Mixture had no significant effect on liver, kidney, or coagulation function indicators (all P>0.05). The Zangsiwei Qingfei Mixture combined with conventional treatment can improve clinical symptoms and promote homeostasis in AECOPD patients, demonstrating safety and reliability. Combining modern medicine with traditional ethnic medicine offers a feasible approach to treating chronic respiratory diseases in the future.

Use of Wearables in Frail Institutionalized Older Adults While Ambulating in Different Environments

(1) Prolonged life expectancy often leads to declining health, reduced physical activity, and dependence, especially in institutionalized elderly. Frailty, obesity, limited functionality, and cognitive impairment are common. Physical activity programs for this demographic can increase weekly energy expenditure and improve frailty. Understanding differences in walking indoors versus outdoors is crucial for tailored programs. This study aimed to compare time, energy expenditure, and perceived exertion in institutionalized elderly walking indoors versus outdoors. It also explored how body mass index and cognitive levels affected these factors. (2) Employing a cross-sectional descriptive observational approach, the study gathered data on height, weight, accelerometers, the modified Borg Scale, the Timed Up and Go test, and the Lobo Cognitive Mini-Exam from a sample of 30 institutionalized older adults. (3) Walking outdoors leads to shorter walking times, higher energy expenditure, and increased perceived effort. Overweight individuals expend more energy in both settings, while cognitive impairment does not significantly impact walking preferences. (4) The study concludes that indoor walking is preferable for frail elderly due to lower perceived exertion, but outdoor walking is recommended for overweight individuals. Cognitive status does not influence the choice of walking environment.

Effect of Home-Based Pulmonary Rehabilitation on Pulmonary Fibrosis.

Pulmonary fibrosis is a chronic, progressive lung condition that involves lung tissue scarring and thickening. The effects of home-based pulmonary rehabilitation (PR) in post-covid pulmonary fibrosis (PCPF) and other forms of fibrosis together have not been evaluated. This study aims to evaluate the effectiveness of home-based pulmonary rehabilitation on pulmonary function, functional capacity, and health-related quality of life in people with pulmonary fibrosis (post-COVID pulmonary fibrosis, pulmonary fibrosis secondary to pulmonary tuberculosis (TB), pulmonary fibrosis secondary to interstitial lung disease(ILD), pulmonary fibrosis secondary to bronchiectasis). A single-group pretest-posttest experimental study was performed after recruiting 98 pulmonary fibrosis subjects from K.M.C hospitals. After being screened for the inclusion and exclusion criteria, 45 subjects were analyzed, and 6 subjects were lost to follow-up. A home-based pulmonary rehabilitation program was carried out for 8 weeks (warm-up, stretching exercises, aerobic exercise, strength training for upper limb and lower limb, breathing exercises mainly involved; others: energy saving techniques, controlled coughing techniques, dyspnea relieving positions). The program was supervised via weekly phone calls. Pulmonary function (Pulmonary function test), exercise capacity (6-minute walk test), dyspnea (modified Borg scale), and health-related quality of life (SF-36) were evaluated before and after the intervention. During the enrollment and after the 6-minute walk test, saturation of peripheral oxygen (SPO2) level was also evaluated pre-intervention and after the 8-weeks program. Pulmonary function [FVC(L) t = -12.52, p<0.05; FEV1(L) t = -2.56, p<0.05; FEV1/FVC t = 7.98, p<0.05 and DLCO (ml/min/mmHg) t = -5.13, p<0.05], 6MWD [MD 88.66; p<0.05] and HRQOL measured by SF-36 scores (p<0.05) were improved significantly. Both the baseline SPO2 level before the 6MWT [MD 1.07, p<0.05] and the SPO2 level after the 6MWT [MD 1.16, p<0.05] showed a significant improvement. The rating of perceived exertion(dyspnea) [MD 1.30, p<0.05] was reduced significantly after the 8-week program. Our study shows that home-based pulmonary rehabilitation is an effective option for improving lung function and physical functional capacity by reducing dyspnea perception and improving the saturation of peripheral oxygen (SPO2) level, and enhancing the quality of life in people with pulmonary fibrosis.

Effects of Different Visual Flow Velocities on Psychophysiological Responses During Virtual Reality Cycling.

Virtual reality cycling (VRC) is simulated outdoor cycling with changes in scenery in virtual reality (VR) with rotating ergometer pedals. The speed at which the scenery changes, which is the visual flow velocity, can shift according to the same pedal rotation speed. This study investigated the effects of different visual flow velocities on the psychophysiological responses of cyclists using the VRC. Participants were asked to cycle for 20 min at 30% of their maximum exercise load under four conditions: (1) bicycle ergometer without VR (control), (2) VRC at normal visual flow velocity (VRC-normal), (3) VRC at 0.5 times the visual flow velocity of VRC-normal (VRC-slow), and (4) VRC at 1.5 times the visual flow velocity of VRC-normal (VRC-fast). The order of the four conditions was randomized in a counterbalanced design. The heart rate and rating of perceived exertion were recorded during the exercise. Participants graded their enjoyment of the task using the physical activity enjoyment scale (PACES). The measured data were analyzed by comparing the visual flow velocity conditions (VRC-slow, VRC-normal, and VRC-fast), and comparing the VRC and bicycle ergometer (VRC-normal and control). A total of 24 participants were enrolled in the study. There was a significant main effect observed in the PACES score (F(2,46)=20.129,p<0.001,partial η2=0.467). In the post-hoc test for the PACES, significant differences were found in the following combinations: VRC-normal > VRC-slow (p=0.005); VRC-fast > VRC-normal (p=0.003); and VRC-fast > VRC-slow (p<0.001). In the modified Borg scale for lower-limb fatigue, there were significant differences in time factor (F(2,46)=134.048, p<0.001, partial η2=0.854) and interaction effects (F(4,92)=3.156, p=0.018, partial η2=0.121). In the post-hoc test for the modified Borg scale, significant trends were found in the following combinations: VRC-normal > VRC-fast (p=0.068) and VRC-slow > VRC-fast (p=0.083). The results suggest that a slower visual flow velocity may reduce the enjoyment of exercise, whereas a faster visual flow velocity may make the exercise feel less fatigued and more enjoyable.

Effectiveness and Outcomes of Noninvasive Positive Pressure Ventilation in Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

Endotracheal intubation and mechanical ventilation in individuals experiencing acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with several complications. Therefore, utilizing noninvasive positive pressure ventilation (NIPPV) is the suggested initial management for these individuals. The current study was done to assess and compare the clinical and physiological parameters before and after the application of NIPPV and also to evaluate the outcomes of NIPPV. A prospective observational study was conducted on 50 patients with COPD experiencing acute exacerbations. These patients were treated with NIPPV. Measurements of blood pressure, respiratory rate (RR), heart rate (HR), dyspnea using the modified Borg scale, and arterial blood gas (ABG) parameters (pH, PaCO2, and PaO2) were recorded at baseline, one hour, six hours, 24 hours, and daily until discharge. The study's outcomes included the subjects who successfully underwent NIPPV and failed during NIPPV. NIPPV effectively reduced the dyspnea score from 7.24 ± 1.58 at baseline to 5.53 ± 1.82 at one hour, 4.11 ± 1.75 at six hours, 2.60 ± 1.03 at 24 hours, and 1.26 ± 0.44 at the time of discharge. Significant improvements were also observed in HRand RR(P < 0.001). When compared to the baseline, the pH level was significantly maintained, PaCO2 was decreased, and PaO2 was increased at various times. Mortality was observed in four patients. NIPPV was successful in 42 (84%)patients, with improvements in ABG and pH for early recovery and reduced hospital stay.

Impact of Computer-Aided Design and Computer-Aided Manufacturing Boston Brace on Level of Dyspnea among Patients with Adolescent Idiopathic Scoliosis

Background: Adolescent Idiopathic Scoliosis (AIS) is a prevalent spinal deformity characterized by a lateral curvature exceeding 10°. Bracing, particularly with the Boston brace, is a common conservative treatment aimed at halting the progression of spinal curvature. However, the impact of bracing on pulmonary function and the resultant dyspnea remains a concern, especially in developing countries like Pakistan where larger scoliotic curves are more common. Objective: This study aimed to evaluate the effect of the CAD/CAM Boston brace on dyspnea levels in patients with AIS and to examine the correlation between dyspnea severity, Cobb's angle, and the duration of brace wear. Methods: Necessary approvals were obtained from the institutional ethical review board, and informed consent was secured from all participants. The study included 145 participants (aged 10-19 years) diagnosed with AIS, recruited through non-probability convenient sampling. The sample size was calculated using the WHO sample size calculator, ensuring a minimum of 134 participants. Data collection involved the 6 Minute Walk Test (6MWT) followed by the Modified Borg Scale (MBS) to assess dyspnea. Participants were instructed to walk a distance of 400 to 700 meters within 6 minutes. Post-test, participants rated their dyspnea on a scale of 0 to 10. Demographic data and brace wear duration were also collected. Data were analyzed using SPSS version 25. Means and standard deviations were calculated for continuous variables, and frequency tables were used for categorical variables. Pearson correlation coefficients were computed to determine the relationships between dyspnea levels, Cobb's angle, and brace wear duration. Results: The mean age of participants was 14.71 years (SD = 2.309). The mean Cobb's angle was 52.08° (SD = 5.3729), and the mean duration of brace wear was 26.08 hours per week (SD = 7.0458). Dyspnea severity varied, with 54.5% of participants reporting "somewhat severe" dyspnea, 15.9% reporting "very, very severe" dyspnea, and 9.0% reporting "moderate" dyspnea. Pearson correlation analysis revealed a strong positive correlation between dyspnea severity and Cobb's angle (r = 0.681), and a moderate positive correlation between dyspnea severity and brace wear duration (r = 0.414). Conclusion: The study highlights the significant impact of the CAD/CAM Boston brace on dyspnea levels among AIS patients. Higher Cobb's angles and longer brace wear durations were associated with increased dyspnea severity. These findings underscore the need for careful monitoring of respiratory symptoms in AIS patients undergoing bracing and suggest exploring alternative or adjunctive treatments to minimize pulmonary compromise.

The association between six-minute walk test and one minute sit to stand test in patients with acute exacerbations of COPD

ABSTRACT Aim: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major complication of COPD and a leading cause of hospitalization, detrimentally affecting functional exercise capacity. The 6-minute walk test (6MWT) is a reliable measure of exercise capacity in chronic lung diseases. Conversely, the 1-minute sit-to-stand test (1STST) offers a simpler assessment of physical function. The aim was to demonstrate the association of functional exercise capacity assessed by 1STST and 6MWT in COPD patients with acute exacerbation. Materials and Methods: In this study, 37 hospitalized patients with acute exacerbation COPD (mean age:66 years) underwent assessments including pulmonary function testing, 6MWT, 1STST and modified Medical Research Council (MMRC). Parameters such as heart rate, oxygen saturation, and perceived dyspnea (via the modified Borg scale) were monitored during tests. Results: The results showed a significant correlation between 6MWT and 1STST performance (r=0.656, p&amp;lt;0.001). Notably, end-tidal oxygen saturation differed between tests, with the 6MWT showing higher end-tidal dyspnea scores. During recovery, 1STST induced increased heart rate and decreased oxygen saturation. Both 6MWT and 1STST were negatively associated with age and MMRC. Positive correlations were observed between 6MWT and FEV1(L) and PEF(L). Conclusions: Similar to the 6MWT, the 1STS test may be used to evaluate how well patients with AECOPD perform during functional exercise. We propose that the 1STST is a suitable alternative to the 6MWT for the assessment of functional exercise performance during hospitalization in AECOPD patients.

Comparison of the effectiveness of the helmet interface using flow meters versus the mechanical ventilator for non-invasive ventilation in patients with coronavirus disease 2019. Controlled and randomized clinical trial

IntroductionThis study aimed to compare the effectiveness of two methods for non-invasive mechanical ventilation in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – using a helmet interface with a flow meter and positive end-expiratory pressure valve versus a traditional mechanical ventilator.Material and methodsWe conducted a single-center randomized clinical trial involving 100 adult SARS-CoV-2 patients in a specialized private hospital. Participants were randomly assigned to two groups: one using the helmet interface with a flow meter and positive end-expiratory pressure valve and the other employing conventional mechanical ventilation. Our study included participant selection, blood gas analysis, assessment of respiratory rate, peripheral oxygen saturation, modified Borg scale scores, and a visual analog scale.ResultsThe study showed no significant difference in intubation rates between the mechanical ventilation (54.3%) and helmet interface with flow meter and positive end-expiratory pressure valve (46.8%) groups (p = 0.37). Additionally, the helmet group had a shorter average duration of use (3.4 ±1.6 days) compared to the mechanical ventilation group (4.0 ±1.9 days). The helmet group also had a shorter average hospitalization duration (15.9 ±7.9 days) compared to the mechanical ventilation group (17.1 ±9.5 days).ConclusionsThis single-center randomized clinical trial found no statistically significant differences between the two methods of non-invasive ventilation. Implications for clinical practice: using the helmet interface with the flow meter and positive end-expiratory pressure valve can simplify device installation, potentially reducing the need for intubation, making it a valuable tool for nurses and physiotherapists in daily clinical practice.

EFFECTS OF FACE MASKS ON CARDIORESPIRATORY PARAMETERS DURING EXERCISE VELOERGOMETRY TEST

The COVID-19 pandemic has sparked ongoing scientific discussions about the adverse effects of wearing face masks on cardiorespiratory indicators, and the subjective response to exertion. Many researchers have investigated the impact of wearing face masks on different physiological factors through various exercise routines, such as a progressive cycling test, the 6-minute walk test, and treadmill walking at a constant pace, yielding inconsistent findings. This study aimed to examine the physiological and perceptual responses of wearing surgical face masks during and after the veloegometry test. Fifteen healthy young adults (mean age, 26.8±4.4 years, 5 males and 10 females) conducted the Astrand-Rhyming veloegometry protocol twice (with and without masks). Physiological outcomes (heart rate, maximal oxygen uptake, and oxygen saturation level), perceived exertion, and discomfort feeling by modified Borg scale were assessed. No significant differences were observed in physiological outcomes with or without masks during increasing load intensities (p &gt; 0.05) except for the last minute of testing and the minute after testing (p ≤ 0.005). Participants wearing masks reported the tendency of higher exertion level (3.8±1.08 vs 4.4±0.9) but statistical analysis can't definitively confirm it. While exercising with a face mask may not adversely affect cardiorespiratory factors, it can elevate perceived exertion levels and discomfort, particularly when exercise intensity exceeds a certain threshold.