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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.

Adv. Respir. Med., Volume 90, Issue 1 (April 2022) – 11 articles

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9 pages, 594 KiB  
Article
Clinical Significance of Basic Laboratory Parameters in Predicting the Use of Various Methods of Oxygen Supplementation in COVID-19
by Ewelina Tobiczyk, Hanna Maria Winiarska, Daria Springer, Ewa Wysocka and Szczepan Cofta
Adv. Respir. Med. 2022, 90(1), 77-85; https://doi.org/10.5603/ARM.a2022.0016 - 28 Jan 2022
Cited by 1 | Viewed by 1738
Abstract
Introduction: The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection resulted in significant worldwide morbidity and mortality. The aim of our study was to evaluate the results of laboratory tests performed on patients on admission to the hospital between groups of [...] Read more.
Introduction: The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection resulted in significant worldwide morbidity and mortality. The aim of our study was to evaluate the results of laboratory tests performed on patients on admission to the hospital between groups of patients requiring and not requiring oxygen supplementation, and to find predictive laboratory indicators for the use of high-flow nasal oxygen therapy (HFNOT)/continuous positive airway pressure (CPAP)/bilevel positive airway pressure (BPAP). Materials and Methods: We retrospectively analysed the data of consecutive patients hospitalised in the Pulmonology Department of the Temporary COVID Hospital in Poznan from February to May 2021. On admission to the department, the patients had a panel of laboratory blood tests. Results: The study group consisted of 207 patients with a mean age of 59.2 ± 15.0 years of whom 179 (72%) were male. During hospitalisation, oxygen supplementation was required by 87% of patients. Patients requiring oxygen supplementation and/or the use of HFNOT/CPAP/BPAP had lower lymphocyte counts and higher levels of urea, C-reactive protein, D-dimer, troponin, glucose, lactate dehydrogenase (LDH) as well as higher white blood cell and neutrophil counts, The parameter that obtained the highest area under curve value in the receiver operator curve analysis for the necessary use of HFNOT/CPAP/BPAP or CPAP/BPAP was LDH activity. Conclusions: Among the basic parameters assessed on admission to the temporary hospital, LDH activity turned out to be the most useful for assessing the need for CPAP/BPAP active oxygen therapy. Other parameters that may be helpful for predicting the need for HFNOT/CPAP/BPAP are serum levels of urea, D-dimer and troponin. Full article
8 pages, 488 KiB  
Article
Comparability of Portable and Desktop Spirometry: A Randomized, Parallel Assignment, Open-Label Clinical Trial
by Piotr Wiktor Boros, Adrian Maciejewski, Michał Maciej Nowicki and Stefan Wesołowski
Adv. Respir. Med. 2022, 90(1), 60-67; https://doi.org/10.5603/ARM.a2022.0013 - 28 Jan 2022
Cited by 6 | Viewed by 1978
Abstract
Introduction: Portable spirometers are often perceived as inaccurate. We aimed to evaluate the performance of AioCare®, a new portable spirometer, by comparing it with a reference desktop spirometer. Materials and Methods: Sixty-two patients diagnosed with asthma or chronic obstructive [...] Read more.
Introduction: Portable spirometers are often perceived as inaccurate. We aimed to evaluate the performance of AioCare®, a new portable spirometer, by comparing it with a reference desktop spirometer. Materials and Methods: Sixty-two patients diagnosed with asthma or chronic obstructive pulmonary disease performed spirometry examinations on a portable and the reference spirometer. The patients were randomized to two groups with different order, in which the spirometers were used. Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow (PEF) and FEV₁/FVC rate were compared. Results: The study revealed a high correlation in FEV₁, FVC, FEV₁/FVC and PEF between portable and reference spirometers. The mean differences between measurements obtained from the AioCare® and reference spirometer were: 0.0079 liter for FEV₁ (p = 0.61), 0.05 liter for FVC (p = 0.14), 5.1 liter/min for PEF (p = 0.28) and –0.0034 for FEV₁/FVC rate (p = 0.54). Pearson correlation coefficient analysis showed high association of FEV₁ (R = 0.994; 95% CI: 0.990–0.997; p < 0.001), FVC (R = 0.984; 95% CI: 0.974–0.990; p < 0.001), PEF (R = 0.965; 95% CI: 0.942–0.979; p < 0.001), and FEV₁/FVC (R = 0.954; 95% CI: 0.924–0.972; p < 0.001) readings from both spirometers. Conclusions: Our results indicate that the portable spirometer produces largely similar readings to those obtained by a stationary spirometer in patients with chronic lung diseases, and therefore it may serve as a complementary tool in daily, remote management of patients with lung diseases. Full article
11 pages, 690 KiB  
Article
Comorbidities Influence the Predictive Power of Hematological Markers for Mortality in Hospitalized COVID-19 Patients
by Ashwaghosha Parthasarathi, Chetak Kadabasal Basavaraja, Sumalata Arunachala, Shreya Chandran, Hariharan Venkataraman, Athira Satheesh and Padukudru Anand Mahesh
Adv. Respir. Med. 2022, 90(1), 49-59; https://doi.org/10.5603/ARM.a2022.0017 - 28 Jan 2022
Cited by 8 | Viewed by 1734
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented mortality and has stretched the health infrastructure thin worldwide, especially in low- and middle-income countries. There is a need to evaluate easily available biomarkers for their clinical relevance for poor outcomes in severe [...] Read more.
Introduction: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented mortality and has stretched the health infrastructure thin worldwide, especially in low- and middle-income countries. There is a need to evaluate easily available biomarkers for their clinical relevance for poor outcomes in severe cases of COVID-19. It is also known that comorbidities affect these biomarkers with or without COVID-19. We aimed to unearth the influence of comorbidities on feasible hematological predictive markers for mortality in hospitalized severe COVID-19 patients. Materials and Methods: This is a retrospective study done on severe COVID-19 hospitalized patients, diagnosed with RT polymerase chain reaction (n = 205), were investigated. Comorbidities associated with the patients were tracked and scored according to Charlson comorbidity index (CCI). CCI score of zero was grouped in A, those with CCI score 1–4 into group B and those with CCI scores ≥ 5 into group C. Correlation between hematological parameters and CCI scores was analyzed using Pearson correlation coefficient. Optimal cut-off and odds ratio was derived from receiver operating characteristic (ROC) curve analysis. Results: Among the 205 severe COVID-19 patients age, C-reactive protein (CRP), neutrophil lymphocyte ratio (NLR), derived NLR (dNLR), absolute neutrophil count (ANC) and total leukocyte count (TLC) were found to be statistically significant independent risk factors for predicting COVID-19 mortality (p < 0.01). In group A, cut off for CRP was 51.5 mg/L (odds ratio [OR]: 26.7; area under curve [AUC]: 0.867), TLC was 11,850 cells/mm³ (OR: 11.7; AUC: 0.731), NLR was 11.76 (OR: 14.3; AUC: 0.756), dNLR was 5.77 (OR: 4.89; AUC: 0.659), ANC was 13,110 cells/mm³ (OR: 1.68; AUC: 0.553). In group B, cut off for CRP was 36.5 mg/L (OR: 32.1; AUC: 0.886), TLC was 11,077 cells/mm³ (OR: 12.1; AUC: 0.722), NLR was 8.27 (OR: 18.9; AUC: 0.827), dNLR was 3.79 (OR: 9.26; AUC: 0.727), ANC was 11,420 cells/mm³ (OR: 2.42; AUC: 0.564). In group C, cut-off for CRP was 23.7 mg/L (OR: 32.7; AUC: 0.904), TLC was 10,480 cells/mm³ (OR: 21.2; AUC: 0.651), NLR was 6.29 (OR: 23.5; AUC: 0.647), dNLR was 1.93 (OR: 20.8; AUC: 0.698), ANC was 6650 cells/mm³ (OR: 2.45; AUC: 0.564). Conclusions: In severe COVID-19 patients, CRP was the most reliable biomarker to predict mortality followed by NLR. Presence, type, and number of co-morbidities influence the levels of the biomarkers and the clinically relevant cut-offs associated with mortality. Full article
3 pages, 132 KiB  
Case Report
Steroids in COVID-19: Tailor-Made or “One Size Fits All”?
by Ayush Goel and Animesh Ray
Adv. Respir. Med. 2022, 90(1), 94-96; https://doi.org/10.5603/ARM.a2022.0005 - 27 Jan 2022
Cited by 2 | Viewed by 1393
Abstract
Since the RECOVERY trial, steroids have endorsed by all Guideliness for treating moderate-severe COVID-19. The prescribed dose is 6mg dexamethasone or its equivalents for 10 days. However, in clinical practice, there are numerous occasions where the role of steroids cannot be extrapolated from [...] Read more.
Since the RECOVERY trial, steroids have endorsed by all Guideliness for treating moderate-severe COVID-19. The prescribed dose is 6mg dexamethasone or its equivalents for 10 days. However, in clinical practice, there are numerous occasions where the role of steroids cannot be extrapolated from current evidence: patients on immunosuppression, patients with persistent oxygen requirement after ten days of therapy, etc. We highlight the existing caveats and the need for further research and discussion. Full article
8 pages, 471 KiB  
Article
The Effect of Albuterol with Heliox versus Albuterol Nebulization in Acute Asthma Exacerbation: A Randomized Controlled Clinical Trial
by Hassan Motamed, Arash Forouzan, Kambiz Masoumi and Rozbeh Sajadi
Adv. Respir. Med. 2022, 90(1), 86-93; https://doi.org/10.5603/ARM.a2022.0009 - 27 Jan 2022
Viewed by 1706
Abstract
Introduction: Asthma is one of the most common chronic disorders of the respiratory tract. Thus, this study intended to evaluate the clinical effects and the peak flow metric effects of nebulized albuterol with heliox versus albuterol nebulization in acute asthma exacerbation. Material [...] Read more.
Introduction: Asthma is one of the most common chronic disorders of the respiratory tract. Thus, this study intended to evaluate the clinical effects and the peak flow metric effects of nebulized albuterol with heliox versus albuterol nebulization in acute asthma exacerbation. Material and Methods: In this randomized clinical trial study, 109 patients with acute asthma attacks admitted to the emergency departments (EDs) in *** were enrolled. The patients were divided randomly into two groups: the intervention and control groups. The intervention group was nebulized with heliox (helium/oxygen-70: 30) plus albuterol with a 10 mL/min dose for 20 min three times, which lasted 60 min. The control group received standard treatment (albuterol in combination with oxygen). Results: The results showed that the mean scores of FEV1 and PEFR after 20 min were significantly different in the two groups, as FEV1 scores in the intervention group were 2.76 and 3.01 at 20 and 60 min, respectively, while FEV1 scores in the control group were 1.99 and 2.64, respectively (p < 0.001). In addition, PEFR scores in the intervention group at 20 and 60 min were 299.24 and 310.57, respectively. However, these scores in the control group were 237.98 and 274.56, respectively (p < 0.001). Conclusion: The results showed that the use of heliox in t eating severe asthma attacks could be regarded as a different standard treatment that can lead to significantly better control of asthma attacks in the short term. Full article
9 pages, 2700 KiB  
Article
Effectiveness of Upper Limb Exercises and Breathing Exercises in COPD Stable Patients During COVID-19 Pandemic Era
by Amira Permatasari Tarigan, Pandiaman Pandia, Agi Hidjri Tarigan and Putri Chairani Eyanoer
Adv. Respir. Med. 2022, 90(1), 68-76; https://doi.org/10.5603/ARM.a2022.0010 - 27 Jan 2022
Cited by 2 | Viewed by 2032
Abstract
Introduction: The objectives of study are to study and to evaluate the benefits and effectiveness of home-based pulmonary rehabilitation in compliance with Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 nonpharmacological initiative for Chronic Obstructive Pulmonary Disease (COPD). Material and Methods [...] Read more.
Introduction: The objectives of study are to study and to evaluate the benefits and effectiveness of home-based pulmonary rehabilitation in compliance with Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 nonpharmacological initiative for Chronic Obstructive Pulmonary Disease (COPD). Material and Methods: This study was a quasi-experiment conducted from August to November 2020 involving 10 COPD stable patients. In the first meeting at the hospital, patients were taught breathing techniques and upper-limb exercise movements which subsequently had to be done and recorded at home. Patients then sent the videos to the research team via whatsapp to be evaluated. Prior to starting the 4-week with twice-a-week frequency home-based rehabilitation, and again at the end of it, patients’ conditions were evaluated based on the following factors: lung functional capacity was measured by 6MWD (6 Minutes Walking Distance), Perceived Exertion Scale by mMRC (modified Medical Research Council) and Borg, the quality of life by SGRQ (St. George’s Respiratory Questionnaire) index, the severity of symptoms by CAT (COPD Assessment Test) and changes in muscle mass. Statistical analysis was conducted using the Wilcoxon and paired t-test. Results: After 4 weeks of home training with twice-a-week frequency, the results showed significant improvement, with p-value < 0.05, in the increased 6MWD value (16.4 ± 4.45 to 19.8 ± 3.64), mMRC (1.90 ± 1.10 to 0.90 ± 0.87), Borg (3.05 ± 1.53 to 1.40 ± 1.42), CAT (15.7 ± 6.63 to 11.8 ± 5.24) and muscle mass (28.36 ± 2.89 to 31.86 ± 3.97). Conclusion: The method produced positive outcomes in patients’ lung function capacity, severity of symptoms, exertion scale, muscle mass, and general quality of life. Accordingly, the home-based rehabilitation programme was as effective as the programme conducted at health-care centers. Full article
12 pages, 374 KiB  
Article
Efficacy Evaluation of Budesonide Nebulizer as an Adjunctive Medication in Post-Rain Asthma Acute Phase Attack
by Ali Vefagh Nematollahi, Hassan Motamed, Kambiz Masoumi, Arash Forouzan and Elnaz Nobakht
Adv. Respir. Med. 2022, 90(1), 37-48; https://doi.org/10.5603/ARM.a2022.0007 - 27 Jan 2022
Cited by 1 | Viewed by 974
Abstract
Introduction: Bronchospasm attacks occur following syndromic rainfall and are increasing due to air pollution and need effective treatments. In this study, the effect of salbutamol nebulizer in comparison with salbutamol plus budesonide nebulizer in patients referred to the emergency department with dyspnea [...] Read more.
Introduction: Bronchospasm attacks occur following syndromic rainfall and are increasing due to air pollution and need effective treatments. In this study, the effect of salbutamol nebulizer in comparison with salbutamol plus budesonide nebulizer in patients referred to the emergency department with dyspnea was investigated. Material and Methods: The trial study was conducted on 228 patients with dyspnea after the first rainfall in Ahvaz. Two groups of 114 patients have been randomly allocated. On the course of treatment, the first group received salbutamol plus budesonide nebulizer and the second group received salbutamol alone. In the experimental group, budesonide 0.5 mg with salbutamol was nebulized three times for 20 min. In all patients, 20, 40, and 60 min after the start of the intervention, forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate (PEFR) and vital signs of size were recorded and analyzed by SPSS and t-test. Results: Data revealed that there were significant differences between PEFR parameters of studied. Groups in minute 40 and 60 after intervention (p = 0.000001). There was better improvement.in PEFR values in minute 40 and 60 in budesonide plus salbutamol study group. There were no significant differences for FEV1 in minute 0, 20, 40, 60 between to studied group. Also there were no significant differences for borg dyspnea scale for minute 0 and 60 between two experimented group. Respiratory rates have significant differences in minutes 20, 40 after intervention and there was better improvement for salbutamol plus budesonide group rather than sulbutamol intervention group alone. (p = 0.001142). Conclusion: Experiment data revealed. that due to the significant difference between PEFR and increased FEV1 in the combination of the two drugs and due to the corticosteroid effects of budesonide in reducing and preventing inflammation and swelling of the lungs, nebulizer salbutamol + budesonide has better effects on moderate breath than in nebulizer salbutamol. Full article
9 pages, 1427 KiB  
Article
Relation of High Resolution Pulmonary CT Findings and Clinical Condition of COVID-19 Patients
by Shereen Farghaly, Gamal Agmy, Sahar Hassany, Shimaa Farghaly, Marwa Makboul and Lamees Mohammed Bakkar
Adv. Respir. Med. 2022, 90(1), 28-36; https://doi.org/10.5603/ARM.a2022.0003 - 26 Jan 2022
Cited by 1 | Viewed by 1700
Abstract
Introduction: At present, chest computed tomography (CT) is accepted as a tool for assessment COVID-19 patients. However, there are few data about the relationship between initial imaging results at presentation and the presence of systemic inflammatory mediators and outcome in patients with [...] Read more.
Introduction: At present, chest computed tomography (CT) is accepted as a tool for assessment COVID-19 patients. However, there are few data about the relationship between initial imaging results at presentation and the presence of systemic inflammatory mediators and outcome in patients with COVID-19. The aim of study is to evaluate the relation of initial high resolution com-puted tomography (HRCT) chest findings to inflammatory indices and clinical course of COVID-19 patients during hospitalization. Material and Methods: This is a retrospective cohort study carried out on 108 confirmed COVID-19 patients. Demographic, laboratory and radiological data were recorded from patients medical records. Based on predominant HRCT density, patients were classified into either normal, ground glass opacity (GGO) and consolidation groups. By HRCT score, patients were classified into either no infilteration, ≤50% infilteration and >50% infilteration groups. Comparison between clinical and laboratory parameters were observed among the groups. Results: More hypoxemia, higher inflammatory indices (CRP, d-dimer, ferritin), more requirement of ventilatory support and more mortality rate were observed in consolidation group compared to GGO (p < 0.05) and in patients with HRCT score > 50% compared to ≤50% infilteration group (p < 0.05). Conclusions: Consolidation pattern and high CT chest quantitative score are associated with elevated inflammatory indices and poor outcome in COVID-19 patients. HRCT chest can be used for risk stratification of COVID-19 patients. Full article
11 pages, 2943 KiB  
Article
Azithromycin Modulates Release of Steroid-Insensitive Cytokines from Peripheral Blood Mononuclear Cells of Patients with Chronic Obstructive Pulmonary Disease
by Aliaksei Kadushkin, Anatoli Tahanovich, Lyudmila Movchan, Elina Talabayeva, Alena Plastinina and Tatiana Shman
Adv. Respir. Med. 2022, 90(1), 17-27; https://doi.org/10.5603/ARM.a2022.0002 - 24 Jan 2022
Cited by 4 | Viewed by 1842
Abstract
Introduction: Oxidative stress reduces responsiveness of peripheral blood mononuclear cells (PBMCs) from patients with chronic obstructive pulmonary disease (COPD) to the anti-inflammatory effects of glucocorticoids (GCs). Azithromycin was shown to modulate corticosteroid resistance mechanisms in COPD patients. However, its ability to enhance [...] Read more.
Introduction: Oxidative stress reduces responsiveness of peripheral blood mononuclear cells (PBMCs) from patients with chronic obstructive pulmonary disease (COPD) to the anti-inflammatory effects of glucocorticoids (GCs). Azithromycin was shown to modulate corticosteroid resistance mechanisms in COPD patients. However, its ability to enhance anti-inflammatory properties of GCs on the production of cytokines by PBMCs has not well been elucidated. Material and Methods: Heparinised blood was collected from 27 patients with COPD. Phytohaemagglutinin-induced release of pro-inflammatory mediators from PBMCs and production of intracellular cytokines by CD4+ and CD8+ T cells stimulated with phorbol 12-myristate 13-acetate and ionomycin in the presence or absence of 10 μg/mL azithromycin and 10 nM budesonide were determined using enzyme linked immunosorbent assay and flow cytometry. Results: Azithromycin decreased the secretion of interleukin (IL) 4, IL-5, IL-13, and IL-17A from PBMCs, as well as the production of IL-4 and IL-8 by CD4+ and CD8+ T cells. The combination of azithromycin and budesonide suppressed inflammatory response by inhibition of IL-4, IL-5, IL-8, IL-13, IL-17A, IL-33, thymic stromal lymphopoietin (TSLP), macrophage migration inhibitory factor (MIF) release from PBMCs and by reduction of the percentage of IL-4-, IL-8-, interferon γ- and tumor necrosis factor a-expressing CD4+ and CD8+ T cells. The inhibitory effect of azithromycin combined with budesonide on IL-4, IL-5, IL-8, IL-17A, TSLP production by PBMCs, as well as IL-4 and IL-8 production by T helper cells and cytotoxic T lymphocytes was significantly greater than the effect of budesonide alone. Conclusions: Azithromycin in combination with budesonide enhances GC properties by inhibiting synthesis of pro-inflammatory cytokines in blood cells of COPD patients. Full article
8 pages, 297 KiB  
Article
Functional Comorbidity Index and Health-Related Quality of Life in Patients with Obstructive Sleep Apnea
by Michalis Agrafiotis, Artemis Galanou, Dimosthenis Fletsios, Anastassia Chassiotou, Diamantis Chloros and Paschalis Steiropoulos
Adv. Respir. Med. 2022, 90(1), 9-16; https://doi.org/10.5603/ARM.a2022.0001 - 24 Jan 2022
Cited by 3 | Viewed by 1073
Abstract
Introduction: The role of comorbidities in determining health-related quality of life (HRQL) in obstructive sleep apnea (OSA) pa-tients has not been thoroughly investigated. Commonly used comorbidity tools, such as Charlson Comorbidity Index (CCI), have been designed with mortality as the outcome variable. [...] Read more.
Introduction: The role of comorbidities in determining health-related quality of life (HRQL) in obstructive sleep apnea (OSA) pa-tients has not been thoroughly investigated. Commonly used comorbidity tools, such as Charlson Comorbidity Index (CCI), have been designed with mortality as the outcome variable. A new tool, the Functional Comorbidity Index (FCI), has been especially developed to assess the effect of comorbidities on the “physical functioning” subscale of the Medical Outcomes Short Form-36 Health Survey (SF-36). (1) To determine the role of FCI in the prediction of the effect of comorbidities on HRQL in OSA. (2) To determine whether FCI and CCI are equally robust in predicting the effect of comorbidities on HRQL in OSA. Material and Methods: Two hundred and fifty-five OSA patients were enrolled. Patients completed the SF-36 and the Medical Outcomes Study Sleep Scale (MOS-SS) forms, while their comorbidity status was assessed by FCI and CCI. The SF-36 physical (PCS-36) and mental component summary (MCS-36) scores were also calculated. Results: PCS-36 was predicted by FCI (p < 0.001), male gender (p = 0.001), BMI (p = 0.002) and the “awakening with “breathlessness/headache” MOS-SS subscale (p = 0.011) (R2 = 0.348). Among these predictors, FCI exerted the most important quantitative effect. MCS-36 was predicted only by the “sleep disturbance” (p = 0.005) and the “awakening with breathlessness/headache” MOS-SS subscales (p < 0.001) (R2 = 0.221). Conclusions: In patients with OSA, FCI is an independent predictor of the physical aspect of their HRQL. FCI is more robust than CCI in assessing the effect of comorbidities on HRQL in OSA. Full article
8 pages, 288 KiB  
Article
Effects of Individualized Target Setting on Step Count in Japanese Patients with Chronic Obstructive Pulmonary Disease: A Pilot Study
by Seigo Sasaki, Yoshiaki Minakata, Yuichiro Azuma, Takahiro Kaki, Kazumi Kawabe and Hideya Ono
Adv. Respir. Med. 2022, 90(1), 1-8; https://doi.org/10.5603/ARM.a2021.0080 - 25 Nov 2021
Cited by 3 | Viewed by 672
Abstract
Introduction: Improving physical activity in patients with chronic obstructive pulmonary disease (COPD) is a very important issue; however, effective recommended targets for individual patients remain to be determined. Material and Methods: We developed a method for setting a target value for [...] Read more.
Introduction: Improving physical activity in patients with chronic obstructive pulmonary disease (COPD) is a very important issue; however, effective recommended targets for individual patients remain to be determined. Material and Methods: We developed a method for setting a target value for the step count for each patient using a measured value and the predicted step count. We then evaluated the effect of providing a pedometer or a pedometer with this target value for eight weeks on the step count in patients with COPD. Results: Sixteen stable COPD patients were included in the analysis. Overall, no significant increase in the step count was obtained by providing the target value; however, when the patients were divided into two groups based on the median step count at baseline, a significant increase in the step count was observed in the low step-count group. In both the overall population and the low step-count group, there was a significant increase in the target achievement rate in patients who received a pedometer with a target value in comparison to patients who were given a pedometer without a target value. Conclusions: Physical activity may be improved by providing a newly developed individual target step count to COPD patients with a low step count at baseline. Full article
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