Pulmonary Rehabilitation Process Research Articles

Chinese Expert Consensus on Perioperative Pulmonary Rehabilitation Training for Lung Cancer

Perioperative pulmonary rehabilitation may effectively reduce the incidence of postoperative pulmonary complications and improve the quality of life of lung cancer patients and its clinical application value in lung cancer patients has been widely recognized. However, there is still no international consensus or guideline for pulmonary rehabilitation regimen, lacking standardized criteria when pulmonary rehabilitation applied in perioperative clinical practice for lung cancer. The consensus provides implementation regimen and process of pulmonary rehabilitation, aiming to promote the reasonable and standardized application of perioperative pulmonary rehabilitation training in clinical practice, sequentially enable patients to maximize benefits from the rehabilitation. .

The Effect of Listening to Pachelbel’s Canon in D Major on Anxiety Level during Pulmonary Rehabilitation: A Pilot Study

Abstract Objective: Many patients with chronic obstructive pulmonary disease (COPD) feel anxious during the pulmonary rehabilitation process. How to reduce the anxious level in patients with COPD is a worthy issue for mental health. Johann Pachelbel’s Canon is a commonly used musical material in clinical practice. In this pilot study, we intended to investigate the effectiveness of using Pachelbel’s Canon in D major as a music therapy to reduce anxiety levels in patients receiving pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD). Methods: Fifty patients with COPD receiving pulmonary rehabilitation from a hospital in New Taipei City. They were randomly assigned in blocks for two groups, control group in a quiet environment, and experimental group listened to the Pachelbel’s canon in D major. Results: A significant difference in the anxiety score during pulmonary rehabilitation between the experimental group and the control group was found through an independent sample t-test in this study (p < 0.05). Conclusion: Listening to the music of Pachelbel’s canon in D Major decreased the anxiety level of patients with COPD during pulmonary rehabilitation.

Pulmonary rehabilitation improves functional outcomes and quality of life in post-SARS-CoV-2 mild-to-moderate infection patients: a pilot study.

SARS-CoV-2 infection impairs functional outcomes and quality of life, even in its mild-to-moderate form. Therefore, it is appropriate to draw attention to the role played by respiratory rehabilitation and physiotherapists in the pulmonary rehabilitation process that post-SARS-CoV-2 patients must undergo. We enrolled 80 patients in a prospective case-control study; 40 cases (mild-to-moderate post-SARS-CoV-2 infection patients) and 38 control subjects (i.e., patients affected by other respiratory diseases) completed the same full pulmonary rehabilitation cycle. 6-minute walking distance, Borg category-ratio 10 scale, modified Medical Research Council (mMRC) dyspnea scale, European quality of life 5-dimensions-3-level (EuroQoL EQ-5D-3L) questionnaire, Barthel scale, arterial blood gas test, and peripheral oxygen saturation were compared for all patients before and after rehabilitation. All patients experienced significant improvements in all parameters analyzed, except for the arterial blood gas test. Results were similar for both groups; in particular, both groups experienced improvements in the mMRC scale, EuroQoL EQ-5D-3L questionnaire, Barthel scale, and 6-minute walking distance. Pulmonary rehabilitation appears to improve exercise tolerance, dyspnea, and quality of life in patients recovering from a mild-to-moderate SARS-CoV-2 infection. Further studies are needed on a larger sample size population to validate these results.

Progress of Muscle Chain Theory in Shoulder Pain Rehabilitation: Potential Ideas for Pulmonary Rehabilitation.

Pulmonary dysfunction is very common in stroke patients. A study has shown that acute stroke patients often cause a series of pulmonary dysfunction due to primary damage to the respiratory center, which is an important reason for hindering disease treatment and recovery. American Thoracic Society (ATS) and the European Respiratory Society (ERS) pointed out that pulmonary rehabilitation (PR) can be applied to the rehabilitation of stroke patients to improve their lung function. PR can improve the respiratory muscle strength of stroke patients, which is beneficial to improving the respiratory function of patients. At the same time, it can also significantly increase the maximum oxygen intake of patients, effectively improve the cardiopulmonary function of stroke patients, and reduce respiratory complications such as aspiration pneumonia. However, the common dysfunction of joints and muscles such as shoulder pain after stroke will affect the process of pulmonary rehabilitation. This is mainly because the changes in the position of the shoulder girdle, the decrease in the range of motion of the cervical and thoracic spine, and the changes in the cervical spondylolisthesis position caused by the elevation of the upper limbs will directly affect the breathing movement during the pulmonary rehabilitation process. The instability of the spine will weaken the deep abdominal muscles and reduce the function of the diaphragm; moreover, changes in the alignment and stability of the cervical and thoracic spine will also lead to wrong breathing methods. Therefore, it is of practical clinical significance to evaluate the functional rehabilitation of shoulder joint muscles and evaluate the efficacy of stroke patients to improve their respiratory function. This article through an extensive review of domestic and foreign literature in recent years, combined with clinical practice experience, summarizes the practical application of chain structure theory in the fields of rehabilitation training, postural adjustment, pain relief, etc., and further studies the functional exercise method based on muscle chain theory. The research on the muscle chain of shoulder pain rehabilitation as a model illustrates the positive effect of reconstructing neuroarticular muscle function on the respiratory system, hoping to provide new ideas for the treatment of respiratory diseases in stroke patients.

Clinical condition, resuscitation and medical-psychological care of severe COVID-19 patients (part 1)

This interview covers the clinical and psychological condition of patients afflicted with severe COVID-19 and their pulmonary rehabilitation process. For these patients, symptoms are medically urgent and life-threatening. The sequelae of this viral attack and immune response to it are significant, and often persist for months after discharge from intensive care. To understand the medical and psychological state of these patients, a description is given of the organs affected, the oxygen cycle in the body and the medical care procedures that are used to help patients with dysfunctional respiratory systems. The link between physical and psychological progress is described. Physical weakness results from pulmonary sequelae and deconditioning, and is often experienced by patients as mental fatigue similar to psychological depression. This may draw the patient into a downward spiral, with multiple health aspects deteriorating, independently of the resolution of initial problems. Conversely, a positive physical or psychological evolution may lead to the evolution of the other. Thus, reversing the negative trend for just one system component can delay, completely arrest the spiralling down, or transform it into an upward spiral, improving the patient's condition. In addition, for people undergoing severe COVID-19, the return to normal life could be destabilizing and memories that arise from their crisis state may trigger Post-Traumatic Stress Disorder (PTSD). Health and psychosocial professionals hold an important role both in post-hospital care and in secondary prevention, i.e. prevention of relapse and re-hospitalization. Physical rehabilitation work must take these psychological factors into account, in the same way that any psychological follow-up is supposed to consider physiological factors.

Recommendations for respiratory rehabilitation of coronavirus disease 2019 in adult

COVID-19 is a highly infectious respiratory infection disease, which leads to dysfunction of respiratory, physical, and psychological of the patients. pulmonary rehabilitation is an important intervention for clinical patients as well as cure patients. With the deeper cognition of COVID-19 and accumulation of clinical experience, we proposed the recommendations for pulmonary rehabilitation of COVID-19 in adults based on the opinions of front-line clinical experts involved in the management of this epidemic and a review of the relevant literature and evidences: (1)for the inpatients with COVID-19, pulmonary rehabilitation would relieve the symptoms of dyspnea, anxiety, and depression; eventually improve physical function and the quality of life; (2)For severe/critical inpatients, the early performance of pulmonary rehabilitation is not suggested. (3)For isolating patients, the pulmonary rehabilitation guidence should be conducted through education video, instruction manual or remote consultation. (4)Assessment and monitor should be performed throughout the entire pulmonary rehabilitation process.(5)Taking proper grading protection following the guideline. These recommendations can serve as a clinical practice guidence and basis for pulmonary rehabilitation of COVID-19.

System of control in the organization of pulmonary rehabilitation of persons with chronic obstructive pulmonary disease

The aim: to substantiate the structural components of the control system aimed at improving the physical therapist’s work during pulmonary rehabilitation (PR) of COPD persons.
 Materials and methods. Analysis and generalization of the data of the special scientific and methodological literature on the issues of physical therapy of patients with chronic obstructive pulmonary disease; method of analysis of medical records; elaboration of Internet sources, including databases of evidence based medical literature.
 Results. The control system, which is reasonable to be implemented at three stages (preliminary, current, final) of the process of physical therapy (PT) and PR of patients with COPD, is substantiated.
 The control system within the competence of the physical therapist provides for rehabilitation examination (preliminary control), monitoring (current control) and final evaluation of certain indicators. There were 5 groups of main indicators: quality of life/ activity and participation, disease course, body functions, body structures, educational competence. For the selected groups of indicators, the selection of measuring instruments was made, the features of their application at different stages were outlined, the values of the minimum clinically significant difference for the selected indicators were given.
 Conclusions. The process of pulmonary rehabilitation of people with COPD needs to be evaluated and monitored for its effectiveness in accordance with the expected results.
 The monitoring system allows to track all changes in the patient's health and functioning, regulate the intervention and its intensity, evaluate both the individual physical therapy session and the effectiveness of the entire program.
 One of the criteria of the control system is the effectiveness of PT and PR, which is evaluated on the basis of the dynamics and direction of changes of the studied indicators, their compliance with the expected result and taking into account the values of the minimal clinically significant difference for the evaluated indicators.

Síndrome EPOC/asma en rehabilitación pulmonar: revisión sistemática - metaanálisis 2010 a 2015

Introducción: revisión sistemática de la literatura sobre estudios aleatorizados en pacientes con EPOC y asma sometidos a rehabilitación pulmonar.Materiales y métodos: se realizó una revisión sistemática en 9 bases de datos, incluida una sobre temas específicos en fisioterapia. Se filtraron los estudios a través de título y resumen, aplicando los criterios de inclusión. Los estudios seleccionados se analizaron utilizando las escalas CONSORT, Jadad y PEDro.Resultados: se filtraron 38 resultados luego de la realización de la búsqueda; de los cuales, 12 publicaciones cumplieron con estándares superiores al ser valorados por al menos 2 de las 3 escalas, siendo caracterizados como buenos o excelentes. Los estudios revisados evidenciaron una alta heterogeneidad en las intervenciones y diseños metodológicos, presentando, en múltiples ocasiones, fallos en el proceso de cegamiento tras la aleatorización.Discusión: no se encontraron resultados en la búsqueda fenotipo mixto-rehabilitación. Un análisis por subgrupo evidenció marcada heterogeneidad en las publicaciones que abordaron el tema EPOC-rehabilitación. No se encontraron publicaciones colombianas de impacto a nivel mundial frente al tema evaluado.Conclusión: de acuerdo con los datos encontrados se concluye que las intervenciones de mayor impacto en el proceso de rehabilitación pulmonar en pacientes con asma y EPOC son inciertos. El análisis por subgrupos evidencia mejoría en la funcionalidad en pacientes con EPOC luego de la aplicación de terapia domiciliaria y medicina tradicional china; no obstante, dada la naturaleza heterogénea de los datos, estos resultados se deben verificar con nuevos estudios que aborden el tema de forma integral.

Pulmonary rehabilitation: Patient and healthcare professional perspective.

A patient and healthcare professional from The Netherlands give an overview of the pulmonary rehabilitation process http://ow.ly/R0iTI

Pulmonary rehabilitation within intensive care units exemplified by traffic collisions casualties

The early introduction of a rehabilitation procedure is of vital importance in the process of acting upon the respiratory system. In comprehensive therapy, pulmonary rehabilitation is perceived as an integral part of treatment for mechanically ventilated patients. The aim of this work was to conduct a comparative analysis of pulmonary rehabilitation concerning patients who had sustained an injury as the result of traffic collisions, and were subsequently treated in an intensive care unit (ICU). Research material consisted of information contained in the medical documentation of 43 patients, ranging in ages from 15 to 57 years, treated in the ICU for injuries sustained during traffic collisions. This analysis involved the values of the parameters recorded first on admission of the patient to the unit, and then every 7 days thereafter, and finally upon discharge from the ICU, and included: arterial blood gasometry, pulsoxymetry, capnometry, body temperature, arterial blood pressure, and pulse rate. Pneumonia occurred most frequently in patients ventilated mechanically during the period from the 15 th to the 28 th day of hospitalization and constituted 60% of the total occurring pneumonias. Deaths were observed more often in patients with acidosis and hypercapnia. Values of arterial oxygen saturation of hemoglobin (SaO 2 ) below 94% were recorded in that group of patients for whom therapeutic procedures ended in failure (40%). For the remaining patients, SaO 2 values exceeded 94%. The analysis of our material showed divergences concerning the values of partial pressure of end-tidal carbon dioxide (PetCO 2 ) and partial pressure of carbon dioxide in the arterial blood (PaCO 2 ). The mean values of SaO 2 and percutaneous monitoring of hemoglobin oxygen saturation (SpO 2 ) were similar. The length of stay within the ICU is significant with respect to the occurrence of complications in the form of pneumonia. Patients whose parameter values were within the norm during pulmonary rehabilitation attained spontaneous respiration at discharge. SpO 2 and PetCO 2 are of vital importance in the pulmonary rehabilitation process, complemented by regularly taken arterial blood gasometry measurements.

Lėtine obstrukcine plaučių liga serganičių ligonių reabilitacija

Pagrindiniai plaučių ligų reabilitacijos tikslai yra lengvinti simptomus, gerinti paciento gyvenimo kokybę ir skatinti fizinį bei emocinį aktyvumą. Sprendžiamos ir kitos problemos: fizinio krūvio toleravimo mažėjimo, santykinės socialinės izoliacijos, nuotaikos sutrikimų, ypač depresijos, raumenų nykimo ir kūno masės mažėjimo. Didžiąją dalį pacientų, kuriems skiriama pulmonologinė reabilitacija, sudaro ligoniai, sergantys lėtine obstrukcine plaučių liga (LOPL). Straipsnyje apžvelgiamos naujausios Amerikos torakalistų bei Europos pulmonologų sąjungos parengtos pulmonologinės reabilitacijos rekomendacijos.

The CNS in multidisciplinary pulmonary rehabilitation: a nursing science perspective.

Although nursing has been described as having an important role to play in the process of pulmonary rehabilitation, the extant literature on multidisciplinary pulmonary rehabilitation has not included a clear articulation of that role or its unique scientific base. The meaning of nursing science-based advanced practice to the team-oriented process of pulmonary rehabilitation is explored from the perspective of Parse's theory of human becoming. Philosophical notions informing practice from this perspective, as well as theory-based advanced nursing practice in pulmonary rehabilitation, are examined. CNS subroles of practice and research are discussed as essential avenues to development of this human science-based approach to advanced practice.