Procjena učinkovitosti rehabilitacije kod pacijenata s KOPB-om u sklopu projekta “PulmoRehab – Pristup zdravstvenim uslugama putem personaliziranog sustava skrbi za pacijente s KOPB, uključujući daljinsko praćenje i tele-rehabilitaciju na temelju metoda umjetne inteligencije”

Katarzyna Bogacz, Anna Szczegielniak, Łukasz Czekaj, Andrzej Jarynowski, Robert Kitłowski, Stanisław Maksymowicz, Danuta Lietz-Kijak, Bartosz Pańczyszak, Jacek Łuniewski, Edyta Krajczy, Mirosław Lenczuk, Jacek Sahajdak, Krzysztof Kassolik, Szymon Kaliciński, Jan Szczegielniak

 

Katarzyna Bogacz, Anna Szczegielniak, Łukasz Czekaj et al – Assessment of rehabilitation effectiveness in patients with COPD as part of the project “PulmoRehab – Access to healthcare services through a personalized care system for patients with COPD, including remote monitoring and tele-rehabilitation based on Artificial Intelligence methods” –  Fizjoterapia Polska 2024; 24(1); 6-11

DOI: https://doi.org/10.56984/8ZG2EF8D9D

Sažetak
Uvod. U projektu “PulmoRehab – Pristup zdravstvenim uslugama putem personaliziranog sustava skrbi za pacijente s KOPB, uključujući daljinsko praćenje i tele-rehabilitaciju na temelju metoda umjetne inteligencije,” Specijalizirana bolnica SP ZOZ Ministarstva unutarnjih poslova i uprave u Głuchołazyju i 10 partnera provelo je istraživanje o tele-rehabilitaciji za osobe koje pate od Kronične opstruktivne plućne bolesti (KOPB). Program tele-rehabilitacije, temeljen na personaliziranom pristupu i tehnologiji, omogućio je pacijentima korištenje terapije kod kuće ili na prikladnoj lokaciji. Cilj projekta bio je smanjenje socijalnih nejednakosti u zdravstvu pružanjem daljinskog pristupa zdravstvenim uslugama za pacijente s KOPB.
Materijali i metode. Studija je uključivala 80 pacijenata u dobi od 50 do 76 godina, hospitaliziranih u Specijalističkoj bolnici Ministarstva unutarnjih poslova i uprave sv. Ivana Pavla II, koji su zadovoljavali određene kriterije. Kvalifikacija za program tele-rehabilitacije uzela je u obzir procjenu tolerancije na vježbanje, dispneje, umora, funkcije ventilacije pluća i saturacije. Program je uključivao vježbe prilagođene individualnim potrebama pacijenata.
Rezultati. Analiza rezultata provedena korištenjem softvera XLSTAT 2021.2.2 pokazala je statistički značajne razlike između spirometrijskih vrijednosti prije i nakon rehabilitacije. Slično tome, značajno poboljšanje primijećeno je u rezultatima testa hodanja na 6 minuta i saturacije krvi. Program tele-rehabilitacije pokazao se učinkovitim u poboljšanju respiratornih zdravstvenih parametara kod pacijenata s KOPB.
Zaključci:
Program tele-rehabilitacije poboljšava funkciju ventilacije pluća kod osoba s KOPB. Smanjuje osjećaj dispneje, umanjuje umor, poboljšava SpO2 i povećava toleranciju na vježbanje, što demonstrira korisne učinke primijenjene rehabilitacije.
Dobiveni rezultati potiču daljnja istraživanja na reprezentativnoj grupi s korištenjem randomizacije.
Ključne riječi:
Tele-rehabilitacija, KOPB
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Effects of suryanamaskar on peak expiratory flow rate and quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD)

Aayushi Palor, D. Anandhi


Aayushi Palor, D. Anandhi – Effects of suryanamaskar on peak expiratory flow rate and quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD). Fizjoterapia Polska 2023; 23(1); 80-86

DOI: https://doi.org/10.56984/8ZG07B401

Abstract
Background. Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. Surya Namaskar is an ancient yogic method to worship the sun. This specific postural and breathing protocols were developed in Indian Subcontinent in the 17th century by Saint Samarth Ramdass. Aim. To find out the effects of Suryanamaskar on peak expiratory flow rate and quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods. Experimental design, pre and post type. 14 COPD patients, aged 35–50 years, both men and women, grade I and II in GOLD classification was randomly allotted into two groups. The patients had to clear the flexibility tests – Sit and reach test and back scratch test. For the Experimental group (n = 7), Suryanamaskar, with conventional chest physiotherapy intervention, was given for 5 days per week for 6 weeks. For the control group (n = 7), conventional chest physiotherapy intervention was given for the same duration. Outcome measures: Peak expiratory flow rate (l/min), SF–36 questionnaire. Results: The study showed that the peak expiratory flow rate and SF–36 questionnaire showed non-significant result for both the groups as p > 0.05, though there was a clinically significant improvement. Conclusion: This study concluded that there is no statistically significant improvement in PEFR and QOL in COPD patients who performed Suryanamaskar along with chest physiotherapy.

Słowa kluczowe:
COPD, Peak expiratory flow rate, QOL, SF–36, Suryanamaskar

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The impact of body composition disorders on the quality of life of patients with chronic obstructive pulmonary disease

Marzena Dorosz, Katarzyna Bogacz, Marta Gołdyn-Pastuszka, Marcin Krajczy, Anna Szczegielniak, Jacek Łuniewski, Jan Szczegielniak


Marzena Dorosz, Katarzyna Bogacz, Marta Gołdyn-Pastuszka, Marcin Krajczy, Anna Szczegielniak, Jacek Łuniewski, Jan Szczegielniak – The impact of body composition disorders on the quality of life of patients with chronic obstructive pulmonary disease. Fizjoterapia Polska 2022; 22(5); 56-69

DOI: https://doi.org/10.56984/8ZG20AXT7

Abstract

Introduction. COPD is a chronic inflammatory disease that constitutes a significant public health problem. It is characterized by not fully reversible, progressive limitation of airflow through the airways. In addition to the harmful pulmonary effects, COPD manifests itself with complications in other body systems, including body composition disorders, which adversely affects patients’ quality of life and prognosis. The objective of this study was to assess the quality of life of patients with COPD and to assess the factors that will affect its deterioration.
Material and methods. The study included 37 patients of the University Hospital at the Jagiellonian University Medical College in Kraków at 8 Skawińska Street, who were diagnosed with COPD according to the GOLD guidelines. In the study group, a personal questionnaire was conducted, anthropometric data was collected, i.e. the Quetelet index was calculated, thigh circumference and skin folds were measured, and the subjective assessment of the quality of life was examined using the SGRQ-C questionnaire and the CAT Test.
Results. Based on the analysis of the collected materials, it was shown that the average assessment of the quality of life in the study population was at a low level of 61.8 points on the SGRQ-C scale. There was a large variation in the assessment of HRQoL depending on the stage of the disease. The best result, amounting to 23.0 points, was achieved by patients in stage 1, and the worst – 81.6 points. – patients in stage 4 according to GOLD guidelines. Among the main determinants of the quality of life in the study group, in addition to the degree of airway obstruction, there were: high intensity of clinical symptoms, such as cough, shortness of breath or expectoration of secretions, low body weight and the number of comorbidities. Conclusions. It has been shown that the loss of fat-free body mass and systemic complications are factors that significantly reduce the quality of life, and patients with fewer comorbidities and with increased BMI score better on the SGRQ-C scale. It has been proven that the progression of the disease contributes to the exclusion of patients from active social life and causes many mental problems. It was established that patients with COPD should be covered by multidisciplinary care and a special training program in order to prevent or delay the onset of systemic complications, which significantly worsen the patients’ quality of life

Keywords:
COPD, body composition, quality of life

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Effect of new reflexology maneuver on lung function and functional ability of chronic obstructive pulmonary disease patients in pulmonary rehabilitation program: A randomized control trial

Laila A. Alsharaway, Tamer I. Abo Elyazed, Nesma A. Helmy

Laila A. Alsharaway, Tamer I. Abo Elyazed, Nesma A. Helmy – Effect of new reflexology maneuver on lung function and functional ability of chronic obstructive pulmonary disease patients in pulmonary rehabilitation program: A randomized control trial. Fizjoterapia Polska 2021; 21(5); 160-165

DOI: https://doi.org/10.56984/8ZG209F33

Abstract
Introduction. Chronic obstructive pulmonary disease (COPD) is a complex disease that requires multidisciplinary interventions provided by a team work of care providers working closely. Pulmonary rehabilitation should be considered a part of integrated patient management.
Aim. The main goal of this study was to search for the effectiveness of introducing new reflexology maneuver as main component in pulmonary rehabilitation program (PRP).
Material and Methods. Randomized control trial was done on 35 COPD patients of both genders their ages ranged from 50-70 with different degrees of functional severity. Patients were grouped into two groups; Reflexology Group (20 patients) including patients underwent classic PRP with addition of the new reflexology maneuver& control group(15 patients) who underwent classic PRP without reflexology maneuver.Outcomes were mentioned as refinement of pulmonary function,exercise tolerance and capacity measured by 6-min walk test,dyspnea score measured by the Modified British Medical Research Council (mMRC) Questionnaire, health status assigned by Combined Assessment test (CAT) score and parameters of blood gases.
Results. Comparison between different variables in both groups before PRP and reflexology revealed statistically significant differences as regards the mean values of forced vital capacity (FVC) only, although the same comparison after full course of PRP and reflexology assigned statistically significant differences as regards the mean values of partial pressure of O2 (PO2), partial pressure of CO2 (PCO2), oxygen saturation (SaO2),forced expiratory volume in 1sec (FEV1), dyspnea &CAT score considering (p < 0.05).
Conclusion. With addition of reflexology to PRP the comprehensive PR program outcomes in COPD patients resulted in significant improvement in dyspnea, blood gases, FEV1 and CAT score.
Key words:
COPD, Pulmonary rehabilitation program, reflexology
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Effects of the halotherapy versus Acapella device on the ventilatory functions in men patients with chronic obstructive pulmonary diseases: A randomized trial

Tarek Abo Elmaged Mohammed, Nesreen Ghareeb Elnahas, Akram Abdel-Aziz said, Alaa Eldin Omar Shelby

Tarek Abo Elmaged Mohammed, Nesreen Ghareeb Elnahas, Akram Abdel-Aziz said, Alaa Eldin Omar Shelby – Effects of the halotherapy versus Acapella device on the ventilatory functions in men patients with chronic obstructive pulmonary diseases: A randomized trial. Fizjoterapia Polska 2021; 21(5); 132-137

Abstract
Purpose. The aim of this study was to compare the effects of the halotherapy versus Acapella device as a method of airway clearance on the response of ventilatory functions in men patients with COPD. Materials and methods. Forty men patients participated in the study with moderate COPD on the basis of spirometric measures (Moderate 50% ≤ FEV1 < 80% of predicted). They were recruited from chest out-patient clinic of Police hospital. Their age ranged from 40 to 60 years and body mass index was 25–30 kg/m2. They were randomly assigned into two groups. Group (A) received treatment by the green Acapella device associated with routine chest physiotherapy including (diaphragmatic breathing, pursed lip breathing and active cycle breathing) for 8 successive weeks, for 24 sessions, 3 times per week, 50 minutes for each session. With 2 sets per each session. Group (B) received halotherapy with natural salt associated with routine chest physiotherapy including (diaphragmatic breathing, pursed lip breathing and active cycle breathing) for 8 successive weeks, for 24 sessions, 3 times per week, 50 minutes for each session. With 2 sets per each session. Ventilatory parameters (FEV1, FVC and FEV1/FVC), six-minute walk distance (6MWD) and the status of the disease by COPD assessment test (CAT) were measured before and after 8 weeks of training. Results. Statistical analysis using the paired t-test between pre and post training showed that group (A) and (B) revealed significant increase in Ventilatory parameters (FEV1%, FVC% and FEV1/FVC%) for group A (7.06%, 1.51%, 5.78%) and for group B (6.7%, 1.95%, 4.96%) respectively, and distance of 6-min walk test with (16.89%) for group A and with (14.5%) for group B and significant decrease in the status of the disease by CAT post-treatment with (22.8%,) for group A and with (20.28%) for group B. Comparing the results among the two tested groups, There was no significant difference in the post-testing mean values of all measured variables between the two groups (A) and (B). Conclusions. Both halotherapy and Acapellla device are similarly effective in ventilatory parameters, distance of 6 min-walk test and COPD assessment test (CAT).
Key words:
COPD, halotherapy, acapella device
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Assessment of training heart rate in patients with chronic obstructive pulmonary disease (COPD)

Ewa Jach, Igor Świerkowski, Piotr Kęsicki, Katarzyna Bogacz, Marcin Krajczy, Krystyna Rasławska, Jacek Łuniewski, Jan Szczegielniak

Ewa Jach, Igor Świerkowski, Piotr Kęsicki, Katarzyna Bogacz, Marcin Krajczy, Krystyna Rasławska, Jacek Łuniewski, Jan Szczegielniak – Assessment of training heart rate in patients with chronic obstructive pulmonary disease (COPD). Fizjoterapia Polska 2021; 21(5); 6-12

Abstract
Objective. The objective of the study was to evaluate the training heart rate in patients with chronic obstructive pulmonary disease.
Material and methods. The study was carried out at the John Paul II Specialist Hospital of the Ministry of Interior and Administration in Głuchołazy at the pulmonary rehabilitation department. Two hundred and five people participated in the study. Each patient included in the study was diagnosed with chronic obstructive pulmonary disease. The group consisted of 100 women and 105 men. Rehabilitation models A and B were used in the study. 155 people were included in model B, and 50 people in model A. The average age was 55. The patients underwent a 6-minute walk test before and after rehabilitation. The following data was included in the study: walk test maximum heart rate, the patient’s maximum heart rate and resting heart rate.
Results. Before rehabilitation, 121 patients achieved a result of over 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, which constitutes 60% of all patients. However, the mean value of this correlation among all patients was 74.69%. After rehabilitation, 143 patients achieved a result of more than 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, which is 70% of all patients. However, the mean value of this correlation among all patients was 79.19%. Before rehabilitation, 205 patients achieved a result of more than 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, which constitutes 99.51% of all patients. While, the mean value of this correlation among all patients was 92%. The number of patients who, before rehabilitation, achieved more than 70% of the values determining the correlation between the 6MWT test heart rate and the submaximal heart rate, was 100% of all patients. The mean value of this correlation among all patients was 90.15%.
Conclusions. 1. The maximum heart rate achieved by patients during the 6-minute walk test corresponds to the maximum heart rate before rehabilitation in 60% of patients, and after rehabilitation in 70% of patients.
2. The maximum heart rate achieved by patients during the 6-minute walk test corresponds to the training heart rate before rehabilitation in 95% of patients, and after rehabilitation in 100% of patients.
3. It seems the maximum heart rate achieved by patients during the 6-minute walk test can be used in determining the patient’s load during exercise.
Key words:
COPD, pulmonology, exercise heart rate, physiotherapy
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Selected aspects of pulmonary rehabilitation

Ryszard Rutkowski, Joanna Rutkowska, Krzysztof Rutkowski, Zenon Siergiejko

Ryszard Rutkowski, Joanna Rutkowska, Krzysztof Rutkowski, Zenon Siergiejko – Selected aspects of pulmonary rehabilitation. Fizjoterapia Polska 2009; 9(1); 21-30

Abstract
Our review article summarizes current knowledge on medical rehabilitation with special emphasis on rehabilitation in respiratory conditions. Medical rehabilitation entails a multidisciplinary approach to chronically ill and disabled patients sen/ing to restore the highest possible physical, mental and professional capacity allowing patients to function actively and independently within the limitations placed upon them by their disorder The beneficial effects of rehabilitation depend considerably on careful planning of action to be taken in the course of treatment of chronic functional disorders and the feasibility of its continuation in the community The American Thoracic Society (ATS) and the European Respiratory Society (ERS) recommend pulmonary rehabilitation in the therapy of chronic respiratory conditions. It has been defined as a multidisciplinary approach providing an indMdually designed multi-speciality programme incorporating the diagnosis, treatment, education and psychological techniąues to stabilise and/or re-vert the physiological and psychopathological symptoms of chronic respiratory conditions. A well designed pulmonary rehabilitation programme encompasses educating patients and their relatives, healthy life style and nutritional (weight correction) advice as well as appropriate psychological intentions. Patient education is the cornerstone of comprehensive pulmonary rehabilitation and remains the shared duty of patients, their families, GPs and all other members of the therapeutic team. Counselling and nutritional advice are important components of the educational programme as they influence patients’ general well-being and fitness.
Key words:
pulmonary rehabilitation, education, asthma, COPD, cystis fibrosis
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Assessment of effectiveness of short-lived physiotherapy procedure on selected functional parameters of the respiratory system in patients with COPD Chronic Obstructive Lung Disease (COLD)

Krystyna Rożek, Jan Szczegielniak, Marta Majewska-Pulsakowska, Anna Dor, Monika Bartczyszyn

Krystyna Rożek, Jan Szczegielniak, Marta Majewska-Pulsakowska, Anna Dor, Monika Bartczyszyn – Assessment of effectiveness of short-lived physiotherapy procedure on selected functional parameters of the respiratory system in patients with COPD Chronic Obstructive Lung Disease (COLD). Fizjoterapia Polska 2012; 12(2); 119-128

Abstract
Background. The objective of the study of short-lived physiotherapy procedure on selected functional parameters of lungs, parameters of arterial blood gas (ABG) and of physical capacity patients with advanced COPD was to assess its effectiveness. Material and methods. examinations were carried out on 40 of the hospitalized men with COPD. Patients were divided in two research groups. Group I -23 men observed a week rehabilitation program based on physiotherapy aimed at raising physical fitness of the patients, group II-control was made of 17 patients in which only pharmacological curing was employed. Functional examinations of the lungs were made with the help of apparatus of German Erich Jaeger FLOWSCREEN equipment. All patients underwent the following examinations: ABG, 6MWT (Six Minutes Walking Test), measurement of BMI (Mass Index Body) and a range of chest mobility. Results. Subjects from Group I, after completion of improvement process, were able to overcome a longer walking distance in a 6-minute walking test, this distance became, however, even shorter, compared to exit results, in the control group patients. However, the average walking speed as well as MET values calculated from the formulae increased in both groups. Parameter FVC significantly increased in group I patients. A significant improvement was also observed amongst studied ABG parameters: pO2 and SaO2 in the experimental group, and a decrease, after the same number of days, in the control group.Conclusions. 1. As a result of the weekly special physiotherapy program the walking distance covered during a 6-minute walking test increased. 2. Among lung function parameters only forced vital capacity increased significantly. 3. After a week of exer­cise pO2 and SaO2 significantly increased in the experimental group.
Key words:
COPD, pulmonary rehabilitation, respiratory function, Exercise Tolerance, POChP
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Rehabilitation models for patients with COPD

Jan Szczegielniak, Jacek Łuniewski, Marcin Krajczy, Katarzyna Bogacz

J.Szczegielniak, J. Łuniewski, M. Krajczy, K. Bogacz – Rehabilitation models for patients with COPD. Fizjoterapia Polska 2019; 19(3); 126-137

Abstract
Rehabilitation program includes models A, B, C, D and E. Key criteria in qualifying patients for adequate rehabilitation models include assessment of exercise tolerance, degree of lung ventilation dysfunction (FEV1 index), dyspnea level and physical function level.
The other criteria considered in the qualification include age, dyspnea and physical function. Patients with contraindications for exercise test and patients with cardiopulmonary insufficiency are qualified for model E. Individual models include cycle ergometer training (up to training heart rate), breathing and general exercises, resistance training or station training, walking, inhalations, postural drainage and effective coughing exercises, as well as chest percussion, physical therapy and massage.

Key words:
rehabilitation program, COPD, rehabilitation models

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Exercise tolerance tests used in physiotherapy for COPD patients.

Jan Szczegielniak, Katarzyna Bogacz, Marcin Krajczy, Jacek Łuniewski

Jan Szczegielniak, Katarzyna Bogacz, Marcin Krajczy, Jacek Łuniewski – Exercise tolerance tests used in physiotherapy for COPD patients. Fizjoterapia Polska 2019; 19(3); 24-30

Abstract
Aerobic training constitutes the basis of COPD patients’ physiotherapy. To establish individualized exercise load for each patient it is necessary to conduct an exercise tolerance test. Exercise tolerance tests allow for adequate planning of endurance training and assessment of its outcomes. Additionally, they are considered a_reliable tool for the assessment of rehabilitation benefits. Exercise tolerance tests are frequently used for physiotherapy qualification, development of training programs, identification of symptoms which reduce exercise effort potential, monitoring of physiotherapy process and assessment of physiotherapy effects.

Key words:
exercise tolerance tests, COPD

 

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