Modified Borg Scale Research Articles

Neural Respiratory Drive During Different Dyspnea Relief Positions and Breathing Exercises in Individuals With COPD.

When the work load of the respiratory muscles increases and/or their capacity decreases in individuals with COPD, respiratory muscle activation increases to maintain gas exchange and respiratory mechanics, and perception of dyspnea occurs. The present study aimed to compare diaphragm and accessory respiratory muscle activation during normal breathing, pursed-lip breathing, and breathing control in different dyspnea relief positions, supine and side lying. A cross-sectional study design was used. Sixteen individuals with COPD age between 40-75 y were included. Pulmonary function was evaluated by spirometry, muscle activation by surface electromyography, and dyspnea by the modified Borg scale. Muscle activation was measured in the diaphragm, scalene, sternocleidomastoid, and parasternal muscles. The evaluation was made in the dyspnea relief positions (sitting leaning forward, sitting leaning forward at a table, leaning forward with back against a wall, standing leaning forward, and high lying), seated erect, supine, and side lying. There were significant differences between the 8 positions (P < .001). There was no significant difference in muscle activation between sitting leaning forward and sitting leaning forward at a table position with analyzing post hoc test results (P > .99 for each muscle). However, muscle activation was lower in these 2 positions than in the other positions (P < .001 for each muscle). Muscle activation was greater in the supine position than in the other positions (P < .001 for each muscle). No difference was observed in muscle activation between the seated erect, leaning forward with back against a wall, standing leaning forward, high-lying, or side-lying positions (P > .05 for each muscle with a minimum P value of .09). The use of sitting leaning forward and sitting leaning forward at a table positions together with breathing control may help people with COPD to achieve more effective dyspnea relief and greater energy efficiency.

Energy expenditure and effort of patients with stroke during sit to stand: A pilot study.

Sit-to-stand (STS) is a mechanically demanding task. Little is known about the energy expenditure (EE) and the perceived effort of patients with stroke during STS. The objectives of our study were to assess the perceived effort and EE of patients with stroke when moving from STS and to determine whether an association between actual energy expended and patient-perceived effort exists. This descriptive cross-sectional pilot study assessed participants' EE and perceived effort during STS, with a triaxial accelerometer and the modified Borg scale (MBS), respectively. The team screened 428 individuals for potential inclusion, with nine participants (n = 5 female, 55.5%) meeting the criteria for our pilot study. Participants had a mean age of 52.77 (standard deviation [SD] ± 11.33) years, the majority had a haemorrhagic stroke (n = 6, 66.6%) and left hemiplegia (n = 6, 66.6%), and they were assessed 9.11 (SD ± 6.57) days post-stroke. The mean EE during STS was 2.82 (SD ± 1.9) kCal. Most participants (n = 7, 77.77%) perceived STS as more than a 'moderate' effort on the MBS. The correlation coefficient between the metabolic equivalent of task (METs) and MBS was r = 0.34 (p = 0.38). Our study found a fair positive correlation between METs and MBS for patients with stroke during STS. The increased EE shown can be a key point for rehabilitation to lessen the extent of EE during STS. Further research is warranted.

Ultrasound in predicting improvement in dyspnoea after therapeutic thoracentesis in patients with recurrent unilateral pleural effusion

ABSTRACT Background In patients with recurrent pleural effusion, therapeutic thoracentesis is one way of relief. Correct prediction of which patients will experience relief following drainage may support the management of these patients. This study aimed to assess the association between ultrasound (US) characteristics and a relevant improvement in dyspnoea immediately following drainage. Methods In a prospective, observational study, patients with recurrent unilateral pleural effusion underwent US evaluation of effusion characteristics and diaphragm movement measured by M-mode and the Area method before and right after drainage. The level of dyspnoea was assessed using the modified Borg scale (MBS). A minimal important improvement in dyspnoea was defined as delta MBS ≥ 1. Results In the 104 patients included, 53% had a minimal important improvement in dyspnoea following thoracentesis. We found no association between US-characteristics, including diaphragm shape or movement (M-mode or the Area method), and a decrease in dyspnoea following drainage. Baseline MBS score ≥ 4 and a fully drained effusion were significant correlated with a minimal important improvement in dyspnoea (OR 3.86 (1.42–10.50), p = 0.01 and 2.86 (1.03–7.93), p = 0.04, respectively). Conclusions In our study population, US-characteristics including assessment of diaphragm movement or shape was not associated with a minimal important improvement in dyspnoea immediately following thoracentesis.

Inspiratory Pressure Threshold Loading: Effects on Inspiratory Pattern, Perception and Prefrontal Cortical Activity

Cognitive awareness of breathing can lead to behavioral ventilatory compensation, respiratory interoception and activation of brain regions associated with decision processes, including the dorsal prefrontal cortex (dPFC). The dPFC is a critical cortical region mediating executive functions and dPFC activity is modulated during increased breathing load. This study investigated load compensation and perception response to sustained breathing against inspiratory pressure threshold (PT) loads. We hypothesized that increasing magnitudes of PT loads require increasing time to valve opening resulting in; greater inspiratory motor drive, increased perception of breathing effort (INT), increased perception of unpleasantness (UPL) and increased dPFC oxygen consumption (OXY, a measure of increased neural activity). Functional near-infrared spectroscopy (fNIRS) was used to measure OXY changes in the dPFC. Healthy subjects were exposed to 5 cmH2O (LoPT) and 20 cmH2O (HiPT) inspiratory PT loads for 1 minute load-on and 1 minute load-off trials. A total of 8 trials for each load were presented, 4 INT trials and 4 UPL trials. Perception of inspiratory INT and UPL was rated with a 0-10 modified Borg scale. There was a significant PT magnitude dependent increase in valve opening duration (0.18±0.15 LoPT vs 0.57±0.17 HiPT) and pressure (-4.4±0.75 LoPT vs -21.3±2.2 HiPT, p&lt;0.001). The pressure-time-product (PtP), a measure of inspiratory motor drive, significantly (p&lt;0.001) increased with PT magnitude. A significant PT magnitude dependent increase in INT (2.8±1.3 vs 7.9±1.2, p&lt;0.001) and UPL (1.9±1.4 vs 7.8±1.4, p&lt;0.001) ratings occurred but perception ratings did not significantly change throughout the 1-minute trial. The average 1-minute trial OXY LoPT was significantly (p&lt;0.02) less than HiPT. The right dPFC OXY did not significantly change between trial Breath 1 and Breath 10. The left dPFC OXY significantly (p&lt;0.01) increased from trial Breath 1 to Breath 10. These results suggest increased PT load magnitude required greater inspiratory drive to breathe. Breathing against a HiPT load was perceived as highly effortful and unpleasant. Sustained breathing against PT loads progressively increased left dPFC neural activity. Supported by the University of Florida, College of Veterinary Medicine. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Altered Functional Connectivity during Mild Transient Respiratory Impairment Induced by a Resistive Load.

Background: Previous neuroimaging studies have identified brain regions related to respiratory motor control and perception. However, little is known about the resting-state functional connectivity (FC) associated with respiratory impairment. We aimed to determine the FC involved in mild respiratory impairment without altering transcutaneous oxygen saturation. Methods: We obtained resting-state functional magnetic resonance imaging data from 36 healthy volunteers during normal respiration and mild respiratory impairment induced by resistive load (effort breathing). ROI-to-ROI and seed-to-voxel analyses were performed using Statistical Parametric Mapping 12 and the CONN toolbox. Results: Compared to normal respiration, effort breathing activated FCs within and between the sensory perceptual area (postcentral gyrus, anterior insular cortex (AInsula), and anterior cingulate cortex) and visual cortex (the visual occipital, occipital pole (OP), and occipital fusiform gyrus). Graph theoretical analysis showed strong centrality in the visual cortex. A significant positive correlation was observed between the dyspnoea score (modified Borg scale) and FC between the left AInsula and right OP. Conclusions: These results suggested that the FCs within the respiratory sensory area via the network hub may be neural mechanisms underlying effort breathing and modified Borg scale scores. These findings may provide new insights into the visual networks that contribute to mild respiratory impairments.

Developing a Novel Prosthetic Hand with Wireless Wearable Sensor Technology Based on User Perspectives: A Pilot Study.

Myoelectric hands are beneficial tools in the daily activities of people with upper-limb deficiencies. Because traditional myoelectric hands rely on detecting muscle activity in residual limbs, they are not suitable for individuals with short stumps or paralyzed limbs. Therefore, we developed a novel electric prosthetic hand that functions without myoelectricity, utilizing wearable wireless sensor technology for control. As a preliminary evaluation, our prototype hand with wireless button sensors was compared with a conventional myoelectric hand (Ottobock). Ten healthy therapists were enrolled in this study. The hands were fixed to their forearms, myoelectric hand muscle activity sensors were attached to the wrist extensor and flexor muscles, and wireless button sensors for the prostheses were attached to each user's trunk. Clinical evaluations were performed using the Simple Test for Evaluating Hand Function and the Action Research Arm Test. The fatigue degree was evaluated using the modified Borg scale before and after the tests. While no statistically significant differences were observed between the two hands across the tests, the change in the Borg scale was notably smaller for our prosthetic hand (p = 0.045). Compared with the Ottobock hand, the proposed hand prosthesis has potential for widespread applications in people with upper-limb deficiencies.

Validation of "CENTR(AR)" walking trails: Different field criteria do not lead to different physical activity intensities in people with COPD

BackgroundValidating walking trails is essential to promote physical activity (PA) safely and confidently in people with COPD. ObjectivesWe aimed to validate predetermined light, moderate, and vigorous intensities of walking trails in people with COPD. MethodsThis cross-sectional study included individuals with COPD walking in predetermined light, moderate and vigorous intensity trails. Activity intensity and volume outcomes were collected. Dyspnoea and fatigue (modified Borg scale), energy expenditure (EE, Sensewear), heart rate (HR, HR monitor), time spent in different PA intensities, and cadence (ActiGraph) were recorded and used to classify PA intensity. ResultsTwenty people with COPD [71(7) years, 80 % male, FEV1%predicted 65.6(11.6)] were included. Fatigue differed significantly between light and moderate [3.0(2.0;4.0) vs 3.4(2.5;4.5), p = 0.01], but not vigorous (3.5[2.5–4.0]) tracks. Dyspnoea [2.3(1.5) vs 2.7(1.6) vs 2.6(1.4)], EE [5.1(0.8) vs 4.9(0.5) vs 4.6(0.8) METs], HR [92.5(11.1) vs 93.7(18.6) vs 95.4(15.0) beats/min] and cadence [115.1(104.0;120.3) vs 104.7(99.6;117.6) vs 111.2(99.9;118.5) steps/min] were similar across trails (p > 0.05). Time spent in light and moderate PA, EE volume, walking time, and step count increased along with the proposed intensity levels (p < 0.01). Walking trails were categorised as moderate intensity in most participants. ConclusionWalking trails were safe and valid for practising moderate-intensity PA in people with COPD. Participants adjusted their physiological responses and perceived symptoms to match a moderate intensity.

Body Awareness in COPD and Its Relation with Patients’ Clinic States

The detection of impairments in body awareness can provide important data for the clinical assessment and treatment planning of patients with COPD. In this study, we aimed to evaluate body awareness in patients with COPD, and to examine its relationship with patients’ clinics. A total of 114 subjects were divided into two groups: the COPD group (n:56) and the control group (n:58). Disease severity (COPD Assessment Test), functional capacity (6 Minute Walk Test), dyspnea (Modified Borg Scale), body awareness (Body Awareness Questionnaire), depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) levels of the groups were evaluated. Compared to the control group, the COPD group had lower levels of body awareness and higher levels of anxiety and depression (p

Post-COVID-19 physical and cognitive impairments and associations with quality of life: a cross-sectional study.

This study aimed to compare physical and cognitive functions between post-coronavirus disease 2019 (COVID-19) participants and healthy matched controls and investigate associations between physical and cognitive impairments with quality of life. Twenty-three post-COVID-19 participants and 23 age and sex-matched healthy people without a history of COVID-19 were included. Physical function was assessed using the Medical Research Council Sum Score (MRC-SS), 2 min Step Test, Modified Borg Scale, and Short Physical Performance Battery (SPPB) Test. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and Stroop test, and the quality of life was evaluated using the Euro Quality of Life-5 Dimensions-3 Levels (EQ-5D-3l) questionnaire. Assessments were performed by a physical therapist in one session. Mann-Whitney U test showed that in the post-COVID-19 group, compared to the control group, the number of steps in the 2 min Step Test (p < 0.001, ES = 0.57) and the scores of the SPPB (p = 0.03, ES = 0.32), MoCA (p = 0.003, ES = 0.44), Stroop test (p < 0.001, ES = 0.75), and the EQ-5D-3l visual analog scale (p = 0.027, ES = 0.32) were significantly lower. In addition, the Modified Borg Scale score (p < 0.001, ES = 0.6), TMT-A (p = 0.013, ES = 0.36) and TMT-B (p = 0.016, ES = 0.35) times, and the Stroop time (p < 0.001, ES = 0.61) were significantly higher in the post-COVID-19 group. There were no significant between-group differences in the MRC-SS score (p = 0.055, ES = 0.28). Furthermore, there were significant moderate to high associations between physical and cognitive functions and the quality of life in post-COVID-19 participants. On average 4 months after symptomatic COVID-19, post-COVID-19 participants had significant impairments in physical and cognitive functions compared to healthy matched controls that were significantly correlated with the quality of life. These findings highlight the need for a comprehensive assessment to plan appropriate management strategies.

Core Function in Adults With Severe Asthma and Its Relationship With Breathing Symptoms

People with asthma may have skeletal muscle dysfunction but data describing core function in severe asthma are limited. To compare core function between people with severe asthma and healthy controls and to determine the difference between males and females. Furthermore, we aimed to investigate the association between core function and breathing symptoms. Adults with a diagnosis of severe asthma and healthy controls undertook an assessment that included 3 core function tests: partial sit-up, Biering-Sorensen, and side bridge. Breathing symptoms were assessed by the modified Medical Research Council dyspnea scale, modified Borg scale, and Nijmegen questionnaire. People with severe asthma (n= 136) (38% male, age median [Q1-Q3] 59 y [45-68], body mass index 30 kg/m2 [26-37]) were compared with 66 people without respiratory disease (47% male, age 55 y [34-65], body mass index 25 kg/m2 [22-28]). There was no difference between groups in the partial sit-up (P= .09). However, participants with severe asthma performed worse with the Biering-Sorensen (P < .001), and the left and right side bridge test (P < .001 for both) than the healthy comparison group. Similar results were found when comparing males and females separately. Males with severe asthma had increased function compared with their female counterparts in the left side bridge test. Core function tests correlated with the breathing symptom measures, the modified Medical Research Council, modified Borg scale, and Nijmegen questionnaire (-0.51 > r > -0.19; P ≤ .03). Adults with severe asthma have worse core function than their control counterparts, independent of sex. Furthermore, as core function decreases, breathing symptoms increase.

Comparative Effects of Buteyko Breathing Technique and Active Cycle of Breathing Technique on Dyspnea and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Background: Chronic Obstructive Pulmonary Disease (COPD) significantly impacts the quality of life due to symptoms like dyspnea. Non-pharmacological interventions, particularly breathing techniques, have gained attention for their potential to improve patient outcomes. Objective: This study aimed to compare the effectiveness of the Buteyko Breathing Technique (BBT) and the Active Cycle of Breathing Technique (ACBT) in reducing dyspnea and enhancing the quality of life in COPD patients. Methods: In a randomized clinical trial conducted at Jinnah Hospital, Lahore, 40 COPD patients (mean age 59.70 ± 5.89 years; 70% male) were assigned to either BBT or ACBT groups. Both groups received standard treatments of bronchodilators and inhaled corticosteroids. The intervention involved three sessions per week for six weeks. Dyspnea was measured using the Modified Borg Scale (MBS), and quality of life was assessed through the St. George’s Respiratory Questionnaire (SGRQ). Normality of data was confirmed via the Shapiro-Wilk test, and parametric tests (paired and independent T-tests) were used for statistical analysis. Results: Pre-treatment MBS in the BBT group was 6.7 ± 1.56, reducing to 2.9 ± 1.21 post-treatment. The SGRQ scores also showed improvement from 71.5 ± 8.44 to 36.8 ± 6.6. In the ACBT group, the MBS score decreased from 7.3 ± 1.56 to 3.95 ± 1.36, and SGRQ scores from 71.6 ± 8.46 to 42.55 ± 6.61. The between-group comparison indicated a more significant improvement in the BBT group, with post-treatment p-values of 0.01 for MBS and 0.009 for SGRQ. Conclusion: Both BBT and ACBT effectively improved dyspnea and quality of life in COPD patients, with BBT showing a greater impact. These findings suggest that BBT could be a preferable non-pharmacological intervention in COPD management. However, individual patient factors should be considered when choosing the appropriate technique.

The effect of acupuncture on exercise capacity in patients with COPD is mediated by improvements of dyspnea and leg fatigue: a causal mediation analysis using data from a randomized controlled trial

BackgroundAcupuncture is known to improve exercise capacity in patients with chronic obstructive pulmonary disease (COPD), but its mechanism remains unknown. Whether acupuncture improves exercise capacity in patients with COPD through alleviation of leg fatigue and dyspnea is examined by applying causal mediation analysis to previous trial data.MethodsSixty-two patients with COPD completed treatments with either real or placebo acupuncture once a week for 12 weeks. Walk distance measured using the 6-minute walk test and intensities of leg fatigue and dyspnea in the modified Borg scale were evaluated at baseline and after treatment. The intervention effect of acupuncture against the placebo acupuncture on two mediators, changes in leg fatigue and dyspnea, and whether they mediated improvements in walk distance, were analyzed.ResultsLinear regression analysis showed that the unstandardized regression coefficients [95% confidence interval (CI)] for the intervention effect by acupuncture were -4.9 (-5.8–-4.0) in leg fatigue and -3.6 (-4.3–-2.9) in dyspnea. Mediation analysis showed that when changes in leg fatigue were considered as a mediator, direct effect, indirect effect and proportion mediated were 47.1 m (95% CI, 4.6–85.1), 34.3 m (-2.1–82.1), and 42.1%, respectively, and when changes in dyspnea were considered as a mediator, they were 9.8 m (-32.9–49.9), 72.5 m (31.3–121.0), and 88.1%, respectively, and the effects of joint mediator were -5.8 m (-55.4–43.9), 88.9 m (32.7–148.5), and 107.0%, respectively.ConclusionThe improvement in exercise capacity by acupuncture is explained by changes in both leg fatigue and dyspnea.

Efficacy of pulmonary rehabilitation plus chest physiotherapy versus chest physiotherapy alone in patients with bronchiectasis

Abstract Context Bronchiectasis is a chronic airway disease characterized by cough, dyspnoea, expectoration, and poor quality of life. Besides medical treatment, regular chest physiotherapy and Pulmonary rehabilitation (PR) may be an effective approach for bronchiectasis. Aims To compare the effects of PR and chest physiotherapy with chest physiotherapy alone in bronchiectasis. Settings and design This randomized controlled trial observational research enrolled 40 cases with bronchiectasis who were categorized into two groups: (group I); 20 cases received PR and chest physiotherapy in addition to medical treatment, (group II): 20 cases received chest physiotherapy in addition to medical treatment. Methods and material Cases were assessed with modified borg scale, 6-minute walk test (6-MWT), arterial blood gases, Spirometry and underwent PR program. Statistical analysis used The same group’s quantitative data were compared using the paired Student’s t-test. The frequency and percentage (%) of qualitative characteristics were displayed. Results In (group I), there was a statistically notable improvement in modified Borg Scale, 6-MWT, arterial oxygen pressure (PaO2), partial pressure of carbon dioxide (PaCO2), arterial oxygen saturation, FEV1 (actual and predicted %values), FVC (actual and predicted %values), FEV1/FVC actual value, sputum volume and training intensity. In (group II) there was a statistically notable improvement in 6-MWT, PaO2, PaCO2, FEV1 (actual and predicted %values), FVC (actual and predicted %values), FEV1/FVC actual value, and sputum volume. The percentage of improvement in all parameters was significantly higher among group (I). Conclusions PR in addition to chest physiotherapy is superior to chest physiotherapy alone in the improvement of symptoms and exercise tolerance in bronchiectasis.

Impact of combined Russian current and threshold PEP on dyspnoea and functional capacity in patients with COPD: a randomised controlled trial

IntroductionExpiratory muscle weakness and dyspnoea are common in patients suffering from chronic obstructive pulmonary disease (COPD) and negatively affect their exercise capacity. We aimed to highlight the combined effect of Russian current and a threshold positive expiratory pressure (PEP) device on expiratory muscle strength, dyspnoea, and functional capacity in patients with COPD.MethodsA total of 60 males with COPD were involved in this controlled randomised trial (age ranged 55–65 years and median body mass index [BMI] was 28.68–25.96) and randomly assigned into two equal groups (30 for each), to receive combined Russian current and PEP device (study group) or PEP device only (control group), for three sessions per week over a ten-week period. Maximum expiratory pressure (MEP), dyspnoea (modified Borg scale – MBS), and functional capacity (6-minute walk test) were assessed before and after the intervention.ResultsThere was statistically significant improvement in all measured variables (MEP, MBS, and 6-minute walk test) in either the study group or the control group according to Wilcoxon’s sign rank test (all were p &lt; 0.001 and p &lt; 0.01, respectively), however, the study group showed a more significant improvement compared to the control group according to the Mann–Whitney U-test (p &lt; 0.001).ConclusionsCombined Russian current and PEP device had a superior beneficial effect on improving dyspnoea and functional capacity by boosting the expiratory muscle strength in COPD patients, which could be implemented in their management, although further studies are needed to evaluate its maintenance effect.

Early rehabilitation challenges of surgical patients with COVID-19 infection - a single-arm study

Background/Aim. A very limited amount of data regarding the rehabilitation outcome of surgical patients with COVID-19 is available in the current literature. The aim of this study was to point out the characteristics of early rehabilitation of these patients and determine the predictors of rehabilitation outcomes. Methods. The study was designed as a prospective clinical trial. It included patients who had surgical treatment from April 1, 2022, to March 31, 2023, at the University Clinical Center of Vojvodina, Serbia and either had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperatively or developed coronavirus disease 2019 (COVID-19) within 72 hrs after surgery. The rehabilitation program was planned for each patient according to the type of surgical treatment, age, clinical presentation and severity of the COVID-19, length of immobilization, and comorbidities. Rehabilitation treatment (RT) started with a minimum of one 30-minute daily session, up to three 30-minute sessions daily. Patients were assessed at the beginning of RT and discharge. Outcomes were assessed with the Modified Borg Scale (MBS) for dyspnoea, Barthel index (BI) for activities of daily living, Six-Minute Walk Test (6MWT) for exercise tolerance, and Timed up and Go (TUG) test for balance and lower limb mobility. Results. A total of 81 patients were included in the study. RT was successful for 42 patients (24 female and 18 male) with an average age of 62.10 ? 20.07 years. These patients exhibited significant functional improvement, which was measured by all tests that assessed rehabilitation outcome at discharge: BI (p &lt; 0.001), MBS (p &lt; 0.001), 6MWT (p &lt; 0.001), and TUG test (p &lt; 0.001). The remaining 31 patients had unsuccessful RT. The binary logistic regression analysis has shown that age (p = 0.009), cardiovascular disease (p = 0.017), and malignancy (p = 0.022) were significant predictors of rehabilitation outcome. Conclusion. Results of the present study implicate that individually tailored RT during the acute phase of COVID-19 in surgical patients is very challenging. Advanced age, cardiovascular disease, and malignancy are predictors of unfavorable outcomes, and careful consideration is needed when planning the treatment for these patients.

Safety and Efficacy of Incentive Spirometer in Covid-19 Pneumonia; a Randomized Clinical Trial.

Various treatment protocols have been recommended since the beginning of the COVID-19 pandemic and have gradually evolved. This study aimed to assess the effectiveness and safety of incentive spirometer exercise (ISE) in outcomes of hospitalized patients with moderate-to-severe COVID-19 pneumonia. A 3-month single-blind, two parallel-armed randomized controlled trial was conducted at Imam Hossein Hospital, Tehran, Iran. Participants aged >18 years with documented COVID-19 pneumonia were randomly allocated to 2 groups of IS (ISE in addition to the usual treatment) and control (usual care alone). The IS group was also asked to perform ISE after discharge for three months. The primary outcomes were peripheral O2 saturation (SpO2), VBG parameters (pCO2, PH, HCO3), dyspnea level measured by Modified Borg Scale (MBS), length of hospital stay (LOS), and respiratory rate (RR). Secondary outcomes included mortality rate, intubation rate (IR), and ICU admission rate. A total of 160 eligible patients were randomly assigned to either the IS (n = 80) or control (n=80) groups. Although there were no significant differences in primary and secondary outcomes between the groups post-intervention, adjusted analysis showed that participants allocated to the IS group had significantly higher SpO2 levels and lower RR, MBS levels, and LOS. Also, the adjusted model analysis showed a marginal statistically significant difference between groups in secondary outcomes, such as IR, the 1-month mortality rate, and the 3-month mortality rate. It seems that adding the ISE to usual care in the early treatment setting of COVID-19 patients resulted in a relatively significant increase in SpO2 levels, improved respiratory status, and marginally decreased LOS. Additionally, ISE minimally reduced ICU admissions and intubation rates, with no significant impact on in-hospital or long-term mortality in patients with COVID-19 pneumonia.

Effects of moderate intensity intermittent training versus continuous training on indices of cardio-metabolic health in women with hyperlipidemia

Background: Moderate intensity intermittent and continuous training are in practice for muscle strengthening and physical activity. These trainings can be used for cardiometabolic health of hyperlipidemic patients. Objective: to determine the effects of moderate-intensity intermittent versus continuous training on indices of cardio-metabolic health in women with hyperlipidemia. Methods: A randomized clinical trial was conducted at Milestone Fitness Gym in Sialkot from August to December 2021. Women between 30 to 40 years old with hyperlipidemia were included by using a non-probability convenience sampling technique. A total of Twenty (n=20) participants were randomly divided into two groups by lottery method. Moderate-intensity intermittent training was given to Group A (n=10), and moderate-intensity continuous training was given to Group B (n=10) by the gym trainer 3 days per week for 5 weeks. The lipid profile for hyperlipidemia, step test, modified Borg Scale and Timed up-and-go test were used for cardiometabolic health and assessed at the baseline and after 5 weeks of training. Results: The mean age was 34±3.43 years. There was no significant difference (p≥0.05) in lipid profile, lipid profile, Borg scale, and time up and go test when between both groups analysis was done. While within-group analysis shows that there was a significant difference (p&lt;0.05) in all outcome measures of both groups. Conclusion: It is concluded that both techniques, moderate-intensity intermittent versus continuous training were effective equally on indices of cardio-metabolic health in women with hyperlipidemia. Keywords: Continuous Training; Moderate Intensity Intermittent Training; Hyperlipidemia

Assessment of the feasibility of 1-min sit-to-stand test in evaluating functional exercise capacity in interstitial lung disease patients.

Six-min walk test (6MWT) is widely used exercise test for the evaluation of interstitial lung disease (ILD). However, the long test duration and need for long and flat surface hinder its routine use. One-min sit-to-stand test (1-STST) is devoid of such limitations, but has been scarcely evaluated. The study was conducted to evaluate the performance of 1-STST by correlating it with 6MWT in ILD patients. Stable ILD patients were prospectively enrolled. After initial spirometry, all patients performed 6MWT and 1-STST following the standard recommendations. Exercise capacity and physiological parameters (heart rate, pulse oxygen saturation, blood pressure and dyspnea [modified Borg scale]) including peripheral oxygen saturation (SpO2) were correlated after the tests using Pearson correlation, Intraclass correlation coefficient (ICC) and kappa (κ) coefficient. The results showed that the mean age of the patients (n=60) was 58.8±11.5 years (male:female=1:1). Repetitions after 1-STST showed significant correlation with 6MWT (r=0.48; P<0.001). Changes in the physiological variables were similar (P>0.05) with good consistency (ICC=0.68-0.95) between 6MWT and 1-STST. Both lowest SpO2 and difference in SpO2 also showed good agreement (ICC=0.86; 95% confidence interval [CI], 0.77-0.92 and ICC=0.68; 95% CI, 0.47-0.81 respectively) and significant correlation (r=0.76 and r=0.52, respectively). 1-STST and 6MWT were consistent in identifying patients having oxygen desaturation ≥4% (κ=0.56; 96% CI, 0.30-0.82). The results demonstrated that the performance of 1-STST was consistent with 6MWT in terms of exercise capacity and change in physiological parameters. 1-STST can be a valid alternative to 6MWT in the assessment of ILD patients, especially in peripheral health centers.

Investigation of the Effects of Remote Online Exercise Training in Individuals Self-Isolating at Home Due to COVID-19 Disease: A Randomized Controlled Study

Objective: Effectiveness of a 4-week telerehabilitation program including thoracic expansion exercises (TEE), non-specific general body exercises (NSGBE), and physical activity recommendations (PAR) which started at quarantine in individuals with acute mild-COVID-19 was investigated in current study. Methods: This is a randomized controlled study which was performed between May 2021 and February 2022. Adult individuals with acute mild-COVID-19 were randomly grouped as training (TG) (telerehabilitation program under supervision for 3 days/week) and control (CG) (home program including TEE and PAR). Dyspnea (Modified Borg Scale and Modified Medical Research Council Dyspnea Scale), chronic fatigue (Checklist Individual Strength Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), balance (Berg Functional Balance Scale) and lower body strength (a 30-s chair stand test) were evaluated remotely in the individuals before and after a 4-week follow-up. Results: Baseline characteristics and balance scores were similar between groups (p&gt;0.05). After 4-week from baseline, there were no significant differences in dyspnea, chronic fatigue, anxiety, depression, balance, and lower body strength between the groups (p&gt;0.05). However, as dyspnea, chronic fatigue, anxiety, and depression scores decreased, lower body strength increased significantly within TG after follow-up (p&lt;0.05). Dyspnea, chronic fatigue, and anxiety scores decreased while lower body strength increased significantly within CG after follow-up (p&lt;0.05). Conclusion: Dyspnea, severe fatigue, anxiety, and depression are commonly observed in individuals with mild-COVID-19 in the acute period. In these individuals, dyspnea perception, chronic fatigue, anxiety, depression, and functional performance improve after a 4-week light-intensity online tele-program applied either supervised or unsupervised. Mild exercises and PAR are safe and effective in these individuals.

The effect of comprehensive rehabilitation on post-COVID-19 syndrome

BackgroundThe present study aimed to investigate the efficacy of a comprehensive rehabilitation program on quality of life, anxiety, fatigue, and functional status in post-COVID-19 patients admitted to a specialized rehabilitation unit. The secondary objective of the study was to compare the differences between vaccinated and unvaccinated patients.ResultsThe single-center prospective study was conducted. Demographics, comorbidities, vaccination, clinical signs and symptoms, and oxygen saturation were assessed. The rehabilitative protocol was created considering the condition of patients, age, the direct impact of COVID-19 on the systems, sequelae, severity of disease, and comorbidities. The comprehensive rehabilitation program through a multidisciplinary team is applied in a stepwise graded manner. The Nottingham Health Profile (NHP), Fatigue Severity Scale (FSS) The Functional Ambulation Categories (FAC), the modified Medical Research Council (mMRC), the Modified Borg Scale, post-COVID-19 Functional Status (PCFS) scale, Hospital Anxiety and Depression Scale (HADS), and the Barthel Index (BI) were used. In total, 39 patients (61.5% men, age 59.7.0 ± 15.6 years) participated in the study. They were discharged home after 37.5 ± 17.6 days stay in the hospital. The most frequently reported persistent symptoms were dyspnea (76.9%), fatigue (69.2%), and myalgia (64.1%). There was a statistically significant improvement in baseline outcomes including BI, HADS, PCFS, FSS, MMRC, Modified Borg Scale, FAC, O2 support, and NHP after the comprehensive rehabilitation program (p < 0.001). The vaccinated patients had older age, high BMI, and shorter duration of rehabilitation (p = 0.003, p = 0.040, p = 0.022, respectively), while unvaccinated patients had higher BI, FSS, PCFS, and FAC.ConclusionThe comprehensive rehabilitation program improves quality of life, reduces fatigue, anxiety, and depression, and regains function in patients with post-COVID-19 syndrome. In addition, vaccinated patients had older ages and shorter duration of rehabilitation, while unvaccinated patients achieved higher functional status and had significantly higher levels of fatigue at discharge.