Saint George's Respiratory Questionnaire Scores Research Articles

Three-Month Variability of Commonly Evaluated Biomarkers in Clinically Stable COPD.

Clinical decisions in chronic obstructive pulmonary disease (COPD) treatment often utilize serially assessed physiologic parameters and biomarkers. To better understand the reliability of these tests, we evaluated changes in commonly assessed biomarkers over 3 months in patients with clinically stable COPD. We performed an observational prospective cohort study of 89 individuals with clinically stable COPD, defined as no exacerbation history within 3 months of enrollment. Biomarkers included lung function and functional performance status, patient-reported outcomes of symptoms and health status, and blood markers of inflammation. The correlation between testing at baseline and at 3-month follow-up was reported as the intraclass correlation coefficient (ICC). "Outliers" had significant variability between tests, defined as >1.645 standard deviations between the two measurements. Differences in clinical features between outliers and others were compared. Participants with COPD (n = 89) were 70.5 ± 6.7 years old, 54 (61%) male, had a 40 pack-year smoking history with 24.7% being current smokers, and postbronchodilator forced expiratory volume in one second (FEV1) 62.3 ± 22.7% predicted. The biomarkers with excellent agreement between the initial and the follow-up measurements were FEV1 (ICC = 0.96), Saint George's Respiratory Questionnaire (SGRQ) (ICC = 0.98), COPD Assessment Test (CAT) (ICC = 0.93) and C-reactive protein (CRP) (ICC = 0.90). By contrast, parameters showing less robust agreement were 6-minute walking distance (ICC = 0.75), eosinophil count (ICC = 0.77), erythrocyte sedimentation rate (ICC = 0.75) and white blood cell count (ICC = 0.48). Individuals with greater variability in biomarkers reported chronic bronchitis more often and had higher baseline SGRQ and CAT scores. Our study evaluated the stability of commonly assessed biomarkers in clinically stable COPD and showed excellent agreement between baseline and three-month follow-up values for FEV1, SGRQ, CAT and CRP. Individuals with chronic bronchitis and more symptomatic disease at baseline demonstrated greater variability in 3-month interval biomarkers.

Relationship Between Asthma Control as Measured by the Asthma Impairment and Risk Questionnaire (AIRQ) and Patient Perception of Disease Status, Health-Related Quality of Life, and Treatment Adherence.

Critical asthma outcomes highlighted in clinical guidelines include asthma-related quality of life, asthma exacerbations, and asthma control. An easy-to-implement measure of asthma control that assesses both symptom impairment and exacerbation risk and reflects the impact of asthma on patients' lives is lacking. Hence, the objective of this study was to assess the Asthma Impairment and Risk Questionnaire (AIRQ®) construct validity relative to patient self-perception of asthma status and validated disease-specific patient-reported outcome (PRO) measures. Baseline data were analyzed from patients (aged ≥ 12 years) with asthma participating in a 12-month observational study assessing the ability of AIRQ to predict exacerbations. At entry, patients completed a sociodemographic questionnaire, AIRQ, 3 questions addressing self-perceived asthma status, Saint George's Respiratory Questionnaire (SGRQ), mini-Asthma Quality of Life Questionnaire (AQLQ), and Adult Asthma Adherence Questionnaire (AAAQ). Descriptive statistics were calculated for demographic and clinical characteristics. AIRQ construct validity was evaluated by assessing correlations between total AIRQ score and patient self-assessments, SGRQ, mini-AQLQ, and AAAQ scores. Comparisons of SGRQ, mini-AQLQ, and AAAQ total and component/domain scores by AIRQ control category were performed using general linear models and Scheffe's post hoc adjustments for pairwise comparisons. A total of 1112 patients were enrolled: 70% female, 78% White, mean (standard deviation) age 43.9 (19.5) years. There were highly significant correlations between AIRQ score and patient self-perception of overall control (r = 0.69; p < 0.001), total SGRQ (r = 0.74, p < 0.001), and mini-AQLQ (r = -0.78, p < 0.001) scores. As AIRQ control category worsened, so did total and domain SGRQ, mini-AQLQ, and AAAQ impediment-to-inhaled-corticosteroid-adherence scores (all pairwise comparisons p < 0.001). Findings demonstrate the construct validity of AIRQ relative to patient self-perception of asthma status, disease-specific PRO measures, and treatment adherence barriers. AIRQ can be a useful instrument to raise awareness of the unrecognized impacts of asthma on patients' lives.

Factors Associated With Persistence of Dyspnea and Change in Health-Related Quality of Life in Patients With COVID-19 After Discharge.

Introduction Coronavirus disease 2019 (COVID-19) is a deadly virus affecting multiple organ systems, predominantly the respiratory system. Dyspnea along with the deterioration of health-related quality of life (HRQoL) is common in COVID-19 patients discharged from a dedicated Coronavirus disease (COVID) hospital. Very few studies in India used HRQoL for the assessment of COVID-19 patients after discharge. Our article aims to assess the factors associated with the persistence of dyspnea and HRQoL in discharged patients of COVID-19. Methods A total of 48 patients were included in this prospective observational study. Ethical approval from Institutional Ethics Committee was obtained before the enrolment of patients. Patients having dyspnea at exertion and during discharge were selected for this study. Modified Medical Research Council (mMRC) scale and modified Borg scale were used for assessing dyspnea on activity, and Saint George's Respiratory Questionnaire (SGRQ) was used to assess HRQoL. Data were collected on the day of discharge (D0) and after 60 days (D60) post-discharge. The significance of changes in parameters from D0 to D60 was evaluated by paired t-test. Results The mean mMRC, modified Borg, and SGRQ scores at D0 were 2.38±0.98, 3.15±2.12, and 45.36±27.32, respectively, which were improved to 0.94±0.86, 0.94±1.27, and 19.22±18.96 at D60. Age showed significant positive correlations with initial modified Borg (r=0.292, p=0.044) and SGRQ (r=0.332, p=0.021) scores. Body mass index showed significant positive correlations with initial mMRC (r=0.352, p=0.014) and SGRQ (r=0.419, p=0.003) scores. Conclusion Our study showed that on discharge, many COVID patients have impaired HRQoL. Many of them also have dyspnea on exertion. With the early institution of standard pulmonary rehabilitation protocol, symptoms and HRQoL improves rapidly in a month. Different influencing factors were identified. Long-term follow-up with a bigger sample size is needed to formulate a management strategy for these patients.

Effects of Active Cycle of Breathing Techniques on quality of life in patients with Chronic Bronchitis

Background: In patients with a range of respiratory disorders such as chronic bronchitis, active cycle of breathing techniques which includes cycle of breathing control, thoracic expansion exercises and forced expiratory technique (FET), appears to have beneficial effects. Objectives: To determine the effectiveness of active cycle of breathing techniques with conventional medicine among chronic bronchitis patients. Methods: A quasi-interventional study was conducted in a physiotherapy department of 600 bedded Ibn-e-Siena Hospital of Multan, from August 2020 to July 2021 with 26 patients in the experimental group who followed the pharmacological and active cycle breathing techniques treatment while the 26 patients in control group patients received the basic routine pharmacological treatment only. Patients were assessed through the help of the Saint George Respiratory Questionnaire (SGRQ) from baseline to 3 months in both groups. Results: Baseline treatment showed mean SGRQ total score was 26.53±27.39 in the control group and 20.0±20.27 (p&lt;0.33) in the experimental group. Assessment after 3 months showed mean SGRQ total score was 14.50±12.26 in control group and 8.11±10.32 (p&lt;0.04) in experimental group. Conclusion: Active cycle of breathing techniques was more effective with conventional medicine among chronic bronchitis patients in comparison with patients with medicine alone. Significant differences was observed in symptoms, activity, impact, and total SGRQ scores of the experimental group.

Effects of Pulmonary Rehabilitation on Systemic Inflammation and Exercise Capacity in Bronchiectasis: A Randomized Controlled Trial.

Bronchiectasis is a chronic condition that is becoming a global health concern. To examine the effects of pulmonary rehabilitation (PR) on systemic inflammation, exercise capacity, and quality of life in participants with bronchiectasis. Participants were randomized to receive PR (outpatient, three weekly sessions for 3 months) or control intervention (usual care + airway clearance therapy + breathing exercises). Data on laboratory (fibrinogen level) and patient-centered outcomes such as physical fitness [6-min walk test (6MWT)] and quality of life were collected. A total of 41 participants were evaluated (20 in the intervention group and 21 in the control group). The magnitude of change between baseline and the end of study was greater in the PR group than in the control group-the 6MWT distance increased by a mean of 54m (54 vs 12m; p < 0.01), fibrinogen showed a significant reduction (fibrinogen -92.8 versus -47.1mg/dl; p < 0.01), and quality of life improved according to Saint George's Respiratory Questionnaire (SGRQ) (-7.5 vs 3.2; p < 0.01), which exceeded the minimal clinically important difference of 4 points. PR effectively improved physical fitness, quality of life, and the degree of systemic inflammation, as reflected by changes in 6 MWT, fibrinogen levels and SGRQ scores. This study supports the inclusion of people with bronchiectasis in supervised PR programs.

The effectiveness of POST-DISCHARGE telerehabilitation practices in COVID-19 patients: Tele-COVID study-randomized controlled trial.

AIMS:We aimed to investigate the effectiveness of a telerehabilitation exercise program performed without requiring any special equipment on the physical condition of COVID-19 subjects.SETTINGS AND DESIGN:This was a randomized controlled study.METHODS:This study included subjects with a history of hospitalization with a diagnosis of COVID-19 and discharged within 4 weeks. The subjects were divided into two groups randomly, namely telerehabilitation group (TeleGr, n = 17) or control group (CGr, n = 17). The TeleGr received breathing and range of motion exercises, active cycle of breathing technique, and an aerobic training 3 days a week for 6 weeks, while CGr received an exercise brochure with the same content. Subjects were evaluated using the modified Medical Research Council (mMRC) dyspnea score for dyspnea, 30 s sit-to-stand test (30STS) and short physical performance battery (SPPB) to determine their physical status, Saint George Respiratory Questionnaire (SGRQ) to assess quality of their life, and Beck Depression Inventory. All evaluations were carried out at home using videoconferencing.RESULTS:A significant improvement was observed in TelerGr in terms of mMRC (P= 0.035), 30STS (P= 0.005), 5 sit-to-stand time which is one of the subtests of SPPB (P = 0.039) and SGRQ scores. Significant improvement was observed only in the pain score in the CGr (P = 0.039). There was a statistically significant difference between the groups in SGRQ activity (P = 0.035) and total (P = 0.042) scores. In addition, more symptomatic improvement was found in TeleGr.CONCLUSION:Telerehabilitation exercise program with less technical equipment is a good alternative treatment method for COVID-19 subjects, which improves the quality of life and symptomatic status of subjects.Clinical Trial Registration Number:nct04402983

Home-based unsupervised pulmonary rehabilitation program improves the respiratory disability in systemic sclerosis patients with dyspnea: an observational prospective study

Dyspnea is a common symptom in Systemic Sclerosis (SSc) that considerably decreases patients' quality of life (QoL). Pulmonary Rehabilitation (PR) mitigates dyspnea impact on daily activities. The aim of this study is to evaluate the effect on respiratory disability of home-based PR in SSc patients with dyspnea. In this observational prospective monocentric study, we screened all dyspneic SSc consecutive patients attending the Rheumatological day hospital in the University hospital of Parma from January 2019 and June 2019. The aim of our study was to understand if a PR unsupervised home-based program could improve respiratory disability in this specific population. Dyspnea was evaluated with the self-administered questionnaires modified Medical Research Council (mMRC) and Saint George's Respiratory Questionnaire (SGRQ).Patients also filled in Short Form 36 (SF36) and the Modified-Health Assessment Questionnaire for SSc (HAQ-MOD). Health Professionals assessed and trained the patients and collected data before PR and at the end of the program. PR consisted in 5 weekly unsupervised sessions for 8 weeks. Wilcoxon test for paired data evaluated the changes after PR. p<0.05 was considered statistically significant. 46 SSc patients were included (43 female). Only 31 (29 female) performed PR as planned (Adherent Group-AG) while the others gave up within the first week (Non-Adherent Group-NAG). All SGRQ domains (Symptoms: from 30 to 18; p=0.0055; Activity: from 47 to 35, p=0.23; Impact from 29 to 25, p=0.044) and SGRQ total score (from 35 to 29; p=0.022) improved in AG. SGRQ scores did not change in NAG as well as SF36 and HAQ-MOD in both groups. The home-based PR program dramatically decreased the effect, frequency and severity of respiratory symptoms. Conversely, it slightly changed the activities causing breathlessness and dyspnea-related social functioning disturbances. PR appears to be a useful tool in treatment strategies aiming to achieve a QoL improvement in SSc patients.

Respiratory health evaluation of construction workers using questionnaire

Relevance . With growing economy and flourishing construction industries the comorbidities among construction workers are also raised. They are exposed to various dust, fumes, noxious gases and vapours making them susceptible to chronic airway diseases like Chronic Obstructive Lung Disease. The aim of the study was to evaluate the respiratory health status of construction workers in an unorganised sector. Materials and Methods . The data collected from National Capital of Delhi region in an unorganised sector of construction workers by using a Saint George Respiratory Questionnaire by the Institute of Occupational Health and Environmental research, Basaidarapur, Delhi, India. All the participant response was noted and the answers were evaluated to see respiratory health status of workers. Total 200 workers were evaluated. Total 182 males and 18 female participated in the study. Results and Discussion . 25% of workers reported poor health at the time of the survey, while only 4% of workers considered their health to be very good. Among the main complaints were indicated: cough, sputum production, shortness of breath, chest infections, attacks of wheezing. The overall mean of Saint George Respiratory Questionnaire core was 33.55. It increases with the working period in the construction field with 21.6% for 10years and 49.1 for 30years experienced workers, while workers with 11 to 20 years of experience, the score was 28.4. The Saint George Respiratory Questionnaire score was 35.1 in 21-30 years of experienced construction workers. Conclusion . As a result of the study, construction workers are found to be at high risk of various respiratory diseases and related disabilities. Participants in this study did not receive any treatment for respiratory problems at any clinic. This means the importance of occupational health education and the use of personal protective equipment and safe working conditions for construction workers.

Impact spécifique du réentraînement à l’exercice sur les symptômes de dépression dans la broncho-pneumopathie chronique obstructive : expérience du Réseau insuffisance respiratoire de Lorraine

Depression is a common comorbidity in COPD patients, worsening their quality of life and their current level of physical activity. Respiratory rehabilitation is therefore highly recommended for COPD patients but only few of them have access to that kind of program. In real life, exercise training is often the only therapeutic activity provided to patients. The aim of this study was to evaluate the specific effect of exercise training on the level of depression (using Beck Depression inventory short form (BDI-SF)) and quality of life in COPD patients [using the Saint George's Respiratory Questionnaire (SGRQ)]. Five hundred and fifteen COPD patients were enrolled in home-based exercise training programs. 421 programs were completed and the data was available for 182 patients (SGRQ, BDI-SF et TE) at T0 and T12. Dyspnoea (mMRC), SGRQ, BDI-SF scores and TE were significantly improved by the exercise training: mMRC 2,7±0,9 vs. 2,3±1,2; SGRQ 45±15 vs 34±18; BDI-SF 4,2±5,1 vs. 2,7±4,3; TE 6,4±5,4 vs. 17,2±12,8 respectively at T0 and T12. The improvement of TE was significantly correlated to that of the SGRQ scores (r=0,4; P<0,001) and of the BDI-SF scores (r=-0,24; P=0,001). This home-based exercise training program improved dyspnoea, quality of life, depression and exercise capacity. The improvement of the TE and BDI-SF scores were correlated.

Effect of inspiratory muscle training on dyspnea-related kinesiophobia in chronic obstructive pulmonary disease: A randomized controlled trial

BackgroundThe major symptom of chronic obstructive pulmonary disease (COPD) is dyspnea, which causes dyspnea-related kinesiophobia resulting in avoidance of activities associated with dyspnea or compensation by reducing the rate of activity. The aim of this study was to assess dyspnea-related kinesiophobia and determine the effect of inspiratory muscle training (IMT) on dyspnea-related kinesiophobia in COPD. MethodsForty COPD subjects were randomly allocated to either the IMT or sham group. Both groups' maximal inspiratory pressure (MIP) was assessed weekly. All patients were instructed to perform the training exercises for 15 min twice a day, 5 days a week for a total of 8 weeks. In the IMT group, intensity was set at 30% of MIP and adjusted according to weekly MIP value. In the sham group, intensity remained constant at 15% of initial MIP. Pulmonary function test (PFT), respiratory muscle strength, 6-min walk test (6 MWT), Breathlessness Beliefs Questionnaire (BBQ), Modified Medical Research Council scale (MMRC), modified Borg scale, Hospital Anxiety and Depression Scale (HADS), Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT) were assessed before and after the intervention. ResultsBBQ scores ranged from 18 to 51, with mean values in the IMT and sham groups of 39.80 ± 7.62 and 43.00 ± 6.58, respectively. When between-group differences of all outcome scores were compared, there was a statistically significant improvement in the IMT group than in the sham group (p < 0.05). After IMT, statistically significant decreases in BBQ and modified Borg scores were observed in within groups (p ≤ 0.001). These decreases were significantly greater in the IMT group (p ≤ 0.001). MMRC decreased significantly only in the IMT group (p < 0.001). There was a statistically significant increase in PFT values in the IMT group (p = 0.007–0.045), but no difference in the sham group (p = 0.129–0.886). Both groups showed statistically significant improvement in respiratory muscle strength, 6 MWT distance, and CAT score after 8 weeks (p < 0.05). All HADS and SGRQ scores decreased significantly in the IMT group (p < 0.001), whereas only the SGRQ activity score decreased significantly in the sham group (p = 0.017). ConclusionsOur study provides data on the presence and level of dyspnea-related kinesiophobia in COPD patients. All patients had BBQ scores higher than 11, indicating dyspnea-related kinesiophobia. IMT reduced BBQ score and improved respiratory function, and exercise capacity. Our results also support the other known benefits of IMT such as reduced dyspnea and symptom perception, decreased anxiety and depression, and improved quality of life.

Brazilian version of the Clinical COPD Questionnaire, administered by interview: reliability and validity measurement properties.

ABSTRACTObjective:To test the reliability, validity, and interpretability of the Brazilian version of the Clinical COPD Questionnaire (CCQ) in patients with COPD. Methods:Fifty patients with COPD completed the CCQ by interview on two occasions. At the first visit, the CCQ was administered twice, by two different raters, approximately 10 min apart; the patients also underwent spirometry and were administered the COPD Assessment Test, the modified Medical Research Council scale, and Saint George’s Respiratory Questionnaire (SGRQ). At the second visit (1-2 weeks later), the CCQ was readministered. We tested the hypothesis that the CCQ total score would correlate positively with the total and domain SGRQ scores (r ≥ 0.5). Results:Of the 50 patients, 30 (60%) were male. The mean age was 66 ± 8 years, and the mean FEV1 was 44.7 ± 17.9% of the predicted value. For all CCQ items, Cronbach’s alpha coefficient (95% CI) was 0.93 (0.91-0.96). To analyze the interrater reliability and test-retest reliability of the CCQ, we calculated the two-way mixed effects model/single measure type intraclass correlation coefficient (0.97 [95% CI: 0.95-0.98] and 0.92 [95% CI: 0.86-0.95], respectively); the agreement standard error of measurement (0.65 for both); the smallest detectable change at the individual level (1.81 and 1.80, respectively) and group level (0.26 and 0.25, respectively); and the limits of agreement (−0.58 to 0.82 and −1.14 to 1.33, respectively). The CCQ total score correlated positively with all SGRQ scores (r ≥ 0.70 for all). Conclusions:The Brazilian version of the CCQ showed an indeterminate measurement error, as well as satisfactory interrater/test-retest reliability and construct validity.

A STUDY ON THE EFFECT OF EXACERBATIONS ON THE QUALITY OF LIFE OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Aim: The main aim of this study is to evaluate the effect of exacerbations on the quality of life of the patients with chronic obstructive pulmonary disease.&#x0D; Materials and Methods: Patients of both the genders and with an age of above 18 years of patients who were diagnosed with COPD were included in this prospective study. Modified British Medical Research Council (m-MRC) Dyspnoea Scale was used to establish functional impairment due to shortness of breath in the study participants. Saint George's Respiratory Questionnaire (SGRQ) was also used to assess the patient’s overall health and quality of life-based on self-report.&#x0D; Results: Among the 110 study participants, 87.3% were males and 12.7% were females. It was observed that majority of the patients were in the age group 51-60 years (43.6%). The most frequently observed co-morbidities were hypertension (22.7%) followed by diabetes mellitus (19.1%). Most of the patients were observed to be with m-MRC grade-3 (42.7%) followed by m-MRC garde-2 (39.1%). The SGRQ score was observed to be increased with increase in the frequency of exacerbations.&#x0D; Conclusion: Clinical Pharmacist should take the responsibility in providing effective evidence based therapeutic recommendations for the better management and well being of the COPD patients.

Validity of the Brazilian version of the COPD assessment test in patients with chronic obstructive pulmonary disease.

COPD Assessment Test (CAT) is a questionnaire defined as one of the main options in the assessment of the impact of Chronic Obstructive Pulmonary Disease on patients' life, according to the Global Initiative on Obstructive Lung Diseases. However, the Consensus-based Standards for the Selection of Health Measurement Instruments-COSMIN 2018 has recently determined a correlation coefficient greater than 0.70 and an optimal sample size must have a hundred subjects, hence, validity of the Brazilian version of this instrument is still not yet proven. To verify the validity of the Brazilian version of the Questionnaire CAT in patients with Chronic Obstructive Pulmonary Disease, comparing it to the Saint George's Respiratory Questionnaire (SGRQ) and correlate it with other outcomes. Observational transversal study with 101 COPD diagnosed subjects who underwent anthropometric data collection, life habits, CAT and SGRQ questionnaires, modified Medical Research Council (mMRC) dyspnoea scale. Spirometry, six-minute walking test (6MWT) and body mass index, Dyspnoea and exercise capacity (BODE). Each evaluative measure was compared to the total CAT score. The validity was considered for a significant Pearson correlation coefficient (r) greater than 0.7. It was observed a strong correlation between the total CAT score and the total SGRQ score (r=0.703; P<0.001), as well as moderate correlation with mMRC (r=0.518; P<0.001). SGRQ Symptoms (r=0.627; P<0.001). SGRQ Activity (r=0.636; P<0.001) and SGRQ Impact (r=0.655; P<0.001). There were similar correlations between CAT and other variables (6MWT, mMRC and BODE) and SGRQ and the same variables. The CAT questionnaire is a valid, reliable and easy-to-use instrument for assessing symptoms and can record the impact of COPD on the patient's quality of life.

The St. George's Respiratory Questionnaire in Pulmonary Sarcoidosis.

The Saint George's Respiratory Questionnaire (SGRQ) is a frequently used tool to assess health status in pulmonary disease patients. However, its performance characteristics in sarcoidosis patients are not well characterized. Data from a clinical trial of 138 symptomatic adults with sarcoidosis were used to examine the performance characteristics of SGRQ. Data were available at both baseline and week 24. Other assessments included FVC, FEV1, ATS dyspnea score, Borg's CR 10 dyspnea score, 6-min walk distance (6MWD), and Short Form-36 Physical Component Summary (SF-36 PCS) score. Baseline SGRQ was 46.8, indicating impaired health status. At baseline, SGRQ total score correlated significantly with % predicted FVC, FEV1, ATS dyspnea score, Borg's CR 10 dyspnea score, 6MWD, and SF-36 PCS (r = - 0.37, - 0.32, 0.57, 0.40, - 0.55, and - 0.80, respectively, p < 0.001). Change from baseline in SGRQ score also statistically significantly correlated with change from baseline in these parameters at week 24: r = - 0.25, - 0.20, 0.30, 0.22, - 0.20, - 0.45, respectively (p < 0.05). The SGRQ correlated with other outcome measures in sarcoidosis initially and with treatment. Improvement in FVC % predicted correlated with improvement in SGRQ. These data suggest the SGRQ may function as a reliable endpoint in clinical sarcoidosis trials.

Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis.

<sec id="st1"> <title>BACKGROUND</title> The association between respiratory impairment and tuberculosis (TB) treatment outcomes is not clear. </sec> <sec id="st2"> <title>METHODS</title> We prospectively evaluated respiratory health status, measured using the Saint George's Respiratory Questionnaire (SGRQ), in a cohort of new adult pulmonary TB cases during and up to 18 months following treatment in India. Associations between total SGRQ scores and poor treatment outcomes of failure, recurrence and all-cause death were measured using multivariable Poisson regression. </sec> <sec id="st3"> <title>RESULTS</title> We enrolled 455 participants contributing 619 person-years at risk; 39 failed treatment, 23 had recurrence and 16 died. The median age was 38 years (interquartile range 26-49); 147 (32%) ever smoked. SGRQ scores at treatment initiation were predictive of death during treatment (14% higher risk per 4-point increase in baseline SGRQ scores, 95%CI 2-28, P = 0.01). Improvement in SGRQ scores during treatment was associated with a lower risk of failure (1% lower risk for every per cent improvement during treatment, 95%CI 1-2, P = 0.05). Clinically relevant worsening in SGRQ scores following successful treatment was associated with a higher risk of recurrence (15% higher risk per 4-point increase scores, 95%CI 4-27, P = 0.004). </sec> <sec id="st4"> <title>CONCLUSION</title> Impaired respiratory health status was associated with poor TB treatment outcomes. The SGRQ may be used to monitor treatment response and predict the risk of death in pulmonary TB. </sec>.

Kronik Obstrüktif Akciğer Hastalığı Olan Yaşlı Kadın ve Erkek Bireylerde Kuadriseps Kas Kuvveti ve Kinezyofobinin Sağlıkla İlgili Yaşam Kalitesi Üzerine Etkisi

Objective: The aim of this study was to investigate the effects of quadriceps muscle strength and kinesiophobia on health-related quality of life in elderly women and men with chronic obstructive pulmonary disease.Methods: After recording the socio-demographic information of individuals, the Visual Analogue Scale (VAS) for pain status, the modified Medical Research Council Scale (mMRCS) for dyspnea, TAMPA Scale for Kinesiophobia (TSK), Saint George Respiratory Questionnaire (SGRQ) for health-related quality of life, and manual dynamometer were used to measure for muscle strength of quadriceps.Results: Seventeen (37.8%) of the 45 participants were female. The mean age and body mass index of females were 71.59±4.84 years and 28.75±6.71 kg/m2, respectively. Kinesiophobia averages were 47.47±7.40 and 41.89±7.65 in women and men, respectively, and SGRQ(Symptom) scores were 75.97±15.87 and 63.89±18.54 in women and men, respectively. Statistical analysis showed that there was a significant difference between men and women between kinesiophobia and SGRQ(Symptom) (p&amp;lt;0.05). There was a correlation between kinesiophobia and SGRQ(Activity), SGRQ(Symptom) and SGRQ(Total) in females and kinesiophobia and SGRQ(Activity), SGRQ(Impact) and SGRQ(Total) in males (p&amp;lt;0.05). The TSK score was found to affect the quality of life, more in women (p&amp;lt;0.05). There was no correlation between pain and quadriceps muscle strength and SGRQ parameters in both men and women (p&amp;gt;0.05). Conclusion: In elderly individuals with COPD, kinesiophobia is an important factor affecting the quality of life and is recommended to increase physical activity, and monitor the physiological, emotional well-being in order to improve quality of life.

HEALTH IMPACT OF EXPOSURE TO COPPER AND ZINC AMONG WORKERS IN A METAL DIE CASTING FOUNDRY IN 10TH RAMADAN CITY

Introduction: Little information is present regarding health impact of copper and zinc exposure among metal die casting workers in Egyptian foundries. Aim of work: 1-To measure blood levels of zinc and copper among the studied groups, 2- To measure the prevalence of respiratory hazards among exposed workers and their impact, 3-To identify other health problems due to copper and zinc exposure such as anemia and respiratory disorders, and lastly 4- To correlate such problems with blood levels of zinc and copper. Material and Methods: A comparative cross-sectional study was conducted among 60 male workers, 30 of them were the exposed group involved in processes like melting. The other 30 were chosen from the administrative departments in the same foundry as the reference group. All workers were interviewed using questionnaire for occupational history, respiratory and other symptoms. Blood samples were taken to measure serum copper and zinc, hemoglobin (Hb), and white blood cells counts (WBCs). Ventilatory functions were assessed too. Results: The study showed no significant difference in the blood levels of zinc and copper among the studied groups. However, symptoms related to copper and zinc toxicity were significantly more prevalent among the exposed group, like respiratory symptoms, symptoms regarding skin, throat and eye irritation, metallic taste in the mouth and exhaustion. Symptoms suggestive of metal fume fever including flue like symptoms, arthralgia, fever, and leukocytosis were more prevalent among the exposed workers, but without significant difference. There was no significant correlation between copper and zinc blood levels and other findings such as; Saint George Respiratory Questionnaire scores, Peak Expiratory Flow Rate scores, mean Hb, and WBCs level. Conclusion: Although there was no significant difference in blood levels of zinc and copper among the studied groups, exposed workers were complaining of different symptoms, one of which was respiratory symptoms that had a significant impact on their social and psychological functioning.

Effectiveness of Chest Physical Therapy in Improving Quality of Life and Reducing Patient Hospital Stay in Chronic Obstructive Pulmonary Disease

Objective: To find out the effectiveness of chest physical therapy along with standard medical treatment versus standard medical treatment alone in improving quality of life and reducing patient's hospital stay in Chronic Obstructive Pulmonary Disease (COPD) patients. Methods: A randomized controlled trial was conducted in a tertiary care hospital of Peshawar, from September 2016 to February 2017. Thirty COPD patients were included in the study. All patients were randomized into control group and experimental group. The experimental group received chest physical therapy along with standard medical treatment while control group received standard medical treatment alone. Results: The mean age of the participants was 54.2±7.2 years. Both groups were similar with respect to age (p-value 0.432) and gender distribution (p-value 0.464). At baseline mean Saint George's respiratory questionnaire (SGRQ) score was 38.1±7.3 for control group while 37.9±9.2 for experimental group (p- value 0.947). The post-treatment mean SGRQ score was 34.6±6.5 for control group while 28.1±8.7 for experimental group with p-value 0.028. The mean hospital stay of control group was 9.26±1.43 days while mean hospital stay of experimental group was 8.20±1.47 days (p-value 0.055). Conclusion: Chest physical therapy combined with standard medical treatment has considerable effect on improving functional status and quality of life of COPD patients. Yet the effect of chest physical therapy in reducing hospital stay in COPD patients is insignificant.

Outcome of pulmonary rehabilitation in patients with stable chronic obstructive pulmonary disease at Chest Department, Zagazig University Hospitals (2014\u20132016)

ContextChronic obstructive pulmonary disease (COPD) is a very disabling disorder that is accompanied by some extrapulmonary manifestations. Pulmonary rehabilitation (PR) is outlined to enhance both physical and psychological condition of patients with chronic chest diseases.AimsWe aimed at evaluating the effectiveness of 8 weeks of outpatient PR on improving breathlessness, quality of life, exercise tolerance, and functional ability in patients with stable COPD.Settings and design A randomized controlled clinical study was conducted.Patients and methodsThe current study was carried out on 80 patients with stable COPD who were classified into group 1, where 40 patients were subjected to usual pharmacological therapy for COPD and PR for 8 weeks, and group 2, where 40 patients were subjected to usual pharmacological therapy only. Both groups were assessed regarding spirometric pulmonary function, arterial blood gases, 6 min walk test, dyspnea score (modified-Medical Research Council), and health-related quality of life [Saint George respiratory questionnaire (SGRQ)]. SPSS 20.0 for windows and MedCalc 13 for windows were used for statistical analysis.ResultsApproximately 50% of patients in group 1 showed improvement in dyspnea, whereas only 25% of patients were improved in group 2. Moreover, there was a statistical significance difference between both patient groups regarding the post-treatment improvement in 6 min walk distance (6MWD) and the post-treatment improvement in the three components of SGRQ score and also in the total SGRQ score (P<0.001). The improvement in 6MWD showed significantly inverse correlation with the baseline age, modified-Medical Research Council, and SGRQ scores, whereas the improvement in 6MWD was significantly directly correlated with the baseline forced expiratory volume in 1 s, forced expiratory volume in 1 s/forced vital capacity, PaO2, and baseline 6MWD.ConclusionPR for patients with stable COPD is an effective tool for improving quality of life, exercise capacity, and dyspnea score.

The Glittre-ADL Test Cut-Off Point to Discriminate Abnormal Functional Capacity in Patients with COPD

ABSTRACTThe study objective was to determine a cut-off point for the Glittre activities of daily living (ADL)test (TGlittre) to discriminate patients with normal and abnormal functional capacity. Fifty-nine patients with moderate to very severe COPD (45 males; 65 ± 8.84 years; BMI: 26 ± 4.78 kg/m2; FEV1: 35.3 ± 13.4% pred) were evaluated for spirometry, TGlittre, 6-minute walk test (6 MWT), physical ADL, modified Medical Research Council scale (mMRC), BODE index, Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). The receiver operating characteristic (ROC) curve was used to determine the cut-off point for TGlittre in order to discriminate patients with 6 MWT < 82% pred. The ROC curve indicated a cut-off point of 3.5 minutes for the TGlittre (sensitivity = 92%, specificity = 83%, and area under the ROC curve = 0.95 [95% CI: 0.89–0.99]). Patients with abnormal functional capacity had higher mMRC (median difference 1 point), CAT (mean difference: 4.5 points), SGRQ (mean difference: 12.1 points), and BODE (1.37 points) scores, longer time of physical activity <1.5 metabolic equivalent of task (mean difference: 47.9 minutes) and in sitting position (mean difference: 59.4 minutes) and smaller number of steps (mean difference: 1,549 minutes); p < 0.05 for all. In conclusion, the cut-off point of 3.5 minutes in the TGlittre is sensitive and specific to distinguish COPD patients with abnormal and normal functional capacity.