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13 pages, 1000 KiB

Open AccessArticle

Enhanced Recovery after Surgery (ERAS) Implementation and Barriers among Healthcare Providers in France: A Cross-Sectional Study

by Augustin Clet, Marin Guy, Jean-François Muir, Antoine Cuvelier, Francis-Edouard Gravier and Tristan Bonnevie

Healthcare 2024, 12(4), 436; https://doi.org/10.3390/healthcare12040436 - 08 Feb 2024

Viewed by 806

Abstract

The implementation of Enhanced Recovery After Surgery (ERAS) is a challenge for healthcare systems, especially in case of patients undergoing major surgery. Despite a proven significant reduction in postoperative complications and hospital lengths of stay, ERAS protocols are inconsistently used in real-world practice, [...] Read more.

The implementation of Enhanced Recovery After Surgery (ERAS) is a challenge for healthcare systems, especially in case of patients undergoing major surgery. Despite a proven significant reduction in postoperative complications and hospital lengths of stay, ERAS protocols are inconsistently used in real-world practice, and barriers have been poorly described in a cohort comprising medical and paramedical professionals. This study aims to assess the proportion of French healthcare providers who practiced ERAS and to identify barriers to its implementation amongst those surveyed. We conducted a prospective cross-sectional study to survey healthcare providers about their practice of ERAS using an online questionnaire. Healthcare providers were contacted through hospital requests, private hospital group requests, professional corporation requests, social networks, and personal contacts. The questionnaire was also designed to explore barriers to ERAS implementation. Identified barriers were allocated by two independent assessors to one of the fourteen domains of the Theoretical Domains Framework (TDF), which is an integrative framework based on behavior change theories that can be used to identify issues relating to evidence on the implementation of best practice in healthcare settings. One hundred and fifty-three French healthcare providers answered the online questionnaire (76% female, median age 35 years (IQR: 29 to 48)). Physiotherapists, nurses, and dieticians were the most represented professions (31.4%, 24.2%, and, 14.4%, respectively). Amongst those surveyed, thirty-one practiced ERAS (20.3%, 95%CI: 13.9 to 26.63). Major barriers to ERAS practice were related to the “Environmental context and resources” domain (57.6%, 95%CI: 49.5–65.4), e.g., lack of professionals, funding, and coordination, and the “Knowledge” domain (52.8%, 95%CI: 44.7–60.8), e.g., ERAS unawareness. ERAS in major surgery is seldom practiced in France due to the unfavorable environment (i.e., logistics issues, and lack of professionals and funding) and a low rate of procedure awareness. Future studies should focus on devising and assessing strategies (e.g., education and training, collaboration, institutional support, the development of healthcare networks, and leveraging telehealth and technology) to overcome these barriers, thereby promoting the wider implementation of ERAS. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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12 pages, 964 KiB

Open AccessFeature PaperArticle

The Non-Paced 3-Minute Sit-to-Stand Test: Feasibility and Clinical Relevance for Pulmonary Rehabilitation Assessment

by Rachel Ernst, Benoit Bouteleux, Marie Malhouitre, Léo Grassion, Maéva Zysman, Pauline Henrot and Mathieu Delorme

Healthcare 2023, 11(16), 2312; https://doi.org/10.3390/healthcare11162312 - 16 Aug 2023

Cited by 1 | Viewed by 1802

Abstract

Pulmonary rehabilitation (PR) improves health-related quality-of-life (HRQoL) in individuals with chronic obstructive pulmonary disease (COPD), notably by increasing exercise tolerance. Easy-to-implement sit-to-stand tests can facilitate the assessment of exercise tolerance in routine practice. This retrospective study conducted in a real-life setting was designed [...] Read more.

Pulmonary rehabilitation (PR) improves health-related quality-of-life (HRQoL) in individuals with chronic obstructive pulmonary disease (COPD), notably by increasing exercise tolerance. Easy-to-implement sit-to-stand tests can facilitate the assessment of exercise tolerance in routine practice. This retrospective study conducted in a real-life setting was designed to describe the non-paced 3-min sit-to-stand test (3-STST) and to evaluate its relationship with HRQoL (VQ11 questionnaire) to identify the determinants of 3-STST performance and to analyze the evolution of 3-STST performance and HRQoL over the course of a community-based PR program. Seventy-one COPD patients (age 69 ± 10 years old; 51% with GOLD spirometric stages III–IV) were included. Mean ± SD 3-STST performance at the initial PR assessment was 43 ± 15 repetitions. This performance was significantly associated with HRQoL and other indicators of clinical severity (lung function, dyspnea, and functional capacities). During the multivariate analysis, younger age, exertional dyspnea with mMRC ≤ 1, and better HRQoL were significantly associated with better 3-STST performance. From the initial to second PR assessment, changes in 3-STST performance were significantly associated with changes in HRQoL. This study provides evidence that the non-paced 3-STST is feasible and might be clinically relevant in the assessment of patients with COPD referred for community-based PR. This test deserves to be prospectively validated. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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10 pages, 470 KiB

Open AccessArticle

How Does the Method Used to Measure the VE/VCO₂ Slope Affect Its Value? A Cross-Sectional and Retrospective Cohort Study

by Martin Chaumont, Kevin Forton, Alexis Gillet, Daryl Tcheutchoua Nzokou and Michel Lamotte

Healthcare 2023, 11(9), 1292; https://doi.org/10.3390/healthcare11091292 - 30 Apr 2023

Cited by 4 | Viewed by 1767

Abstract

Cardiopulmonary exercise testing (CPET) was limited to peak oxygen consumption analysis (VO₂peak), and now the ventilation/carbon dioxide production (VE/VCO₂) slope is recognized as having independent prognostic value. Unlike VO₂peak, the VE/VCO₂ slope does not require maximal [...] Read more.

Cardiopulmonary exercise testing (CPET) was limited to peak oxygen consumption analysis (VO₂peak), and now the ventilation/carbon dioxide production (VE/VCO₂) slope is recognized as having independent prognostic value. Unlike VO₂peak, the VE/VCO₂ slope does not require maximal effort, making it more feasible. There is no consensus on how to measure the VE/VCO₂ slope; therefore, we assessed whether different methods affect its value. This is a retrospective study assessing sociodemographic data, left ventricular ejection fraction, CPET parameters, and indications of patients referred for CPET. The VE/VCO₂ slope was measured to the first ventilatory threshold (VT1-slope), secondary threshold (VT2-slope), and included all test data (full-slope). Of the 697 CPETs analyzed, 308 reached VT2. All VE/VCO₂ slopes increased with age, regardless of test indications. In patients not reaching VT2, the VT1-slope was 32 vs. 36 (p < 0.001) for the full-slope; in those surpassing VT2, the VT1-slope was 29 vs. 33 (p < 0.001) for the VT2-slope and 37 (all p < 0.001) for the full-slope. The mean difference between the submaximal and full-slopes was ±4 units, sufficient to reclassify patients from low to high risk for heart failure or pulmonary hypertension. We conclude that the method used for determining the VE/VCO₂ slope greatly influences the result, the significant variations limiting its prognostic value. The calculation method must be standardized to improve its prognostic value. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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10 pages, 862 KiB

Open AccessArticle

Breathing Control Exercises Delivered in a Group Setting for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

by Sibylle Cazorla, Yves Busegnies, Pierre D’Ans, Marielle Héritier and William Poncin

Healthcare 2023, 11(6), 877; https://doi.org/10.3390/healthcare11060877 - 17 Mar 2023

Cited by 1 | Viewed by 2075

Abstract

Breathing control exercises are an important component of occupational therapy in patients with chronic obstructive pulmonary disease (COPD). Delivering these exercises in group settings may enhance their benefits. Therefore, this study assessed the effectiveness of breathing control exercises delivered in a group format [...] Read more.

Breathing control exercises are an important component of occupational therapy in patients with chronic obstructive pulmonary disease (COPD). Delivering these exercises in group settings may enhance their benefits. Therefore, this study assessed the effectiveness of breathing control exercises delivered in a group format to patients with severe COPD remitting from an acute pulmonary exacerbation. This randomized controlled trial of 6 weeks’ duration compared the addition of breathing exercise sessions delivered in a group setting to a standard exercise inpatient rehabilitation program (usual care) versus usual care alone. The standard exercise program consisted of endurance and strength training and therapeutic patient education. The intervention group received, in addition to usual care, 20 sessions of 30 min duration of breathing control exercises in a group setting. The primary outcome was quality of life (Saint George’s Respiratory Questionnaire). Secondary outcomes were the COPD assessment test, modified Borg scale, handgrip strength test, and five-time sit-to-stand test. Thirty-seven patients aged 69 ± 7 years were recruited. After the 6-week period, all outcomes significantly improved and exceeded the minimal clinically important difference in the intervention group only. Between-group changes were significant for each outcome. Conclusions: breathing control exercises in a group setting provide clinically relevant benefits in patients with severe COPD who are remitting from an acute pulmonary exacerbation. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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12 pages, 1962 KiB

Open AccessArticle

Responses of Bilevel Ventilators to Unintentional Leak: A Bench Study

by Marius Lebret, Emeline Fresnel, Nathan Prouvez, Kaixian Zhu, Adrien Kerfourn, Jean-Christophe Richard and Maxime Patout

Healthcare 2022, 10(12), 2416; https://doi.org/10.3390/healthcare10122416 - 30 Nov 2022

Cited by 2 | Viewed by 1441

Abstract

Background: The impact of leaks has mainly been assessed in bench models using continuous leak patterns which did not reflect real-life leakage. We aimed to assess the impact of the pattern and intensity of unintentional leakage (UL) using several respiratory models. Methods: An [...] Read more.

Background: The impact of leaks has mainly been assessed in bench models using continuous leak patterns which did not reflect real-life leakage. We aimed to assess the impact of the pattern and intensity of unintentional leakage (UL) using several respiratory models. Methods: An active artificial lung (ASL 5000) was connected to three bilevel-ventilators set in pressure mode; the experiments were carried out with three lung mechanics (COPD, OHS and NMD) with and without upper airway obstruction. Triggering delay, work of breathing, pressure rise time, inspiratory pressure, tidal volume, cycling delay and the asynchrony index were measured at 0, 6, 24 and 36 L/min of UL. We generated continuous and inspiratory UL. Results: Compared to 0 L/min of UL, triggering delays were significantly higher with 36 L/min of UL (+27 ms) and pressure rise times were longer (+71 ms). Cycling delays increased from −4 [−250–169] ms to 150 [−173–207] ms at, respectively 0 L/min and 36 L/min of UL and work of breathing increased from 0.15 [0.12–0.29] J/L to 0.19 [0.16–0.36] J/L. Inspiratory leakage pattern significantly increased triggering delays (+35 ms) and cycling delays (+263 ms) but decreased delivered pressure (−0.94 cmH₂O) compared to continuous leakage pattern. Simulated upper airway obstruction significantly increased triggering delay (+199 ms), cycling delays (+371 ms), and decreased tidal volume (−407 mL) and pressure rise times (−56 ms). Conclusions: The pattern of leakage impacted more the device performances than the magnitude of the leakage per se. Flow limitation negatively reduced all ventilator performances. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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9 pages, 444 KiB

Open AccessEditor’s ChoiceArticle

Benefits of Cardio-Pulmonary Rehabilitation in Moderate to Severe Forms of COVID-19 Infection

by Clara Douin, Kevin Forton, Michel Lamotte, Alexis Gillet and Philippe Van de Borne

Healthcare 2022, 10(10), 2044; https://doi.org/10.3390/healthcare10102044 - 17 Oct 2022

Cited by 4 | Viewed by 1434

Abstract

Our aim was to evaluate the benefits of cardio-pulmonary rehabilitation on severe to moderate COVID-19 patients. 25 discharged COVID-19 patients underwent a cardio-pulmonary test (CPET), a spirometry test and a measure of carbon monoxide lung diffusion capacity (DLCO) at the beginning of their [...] Read more.

Our aim was to evaluate the benefits of cardio-pulmonary rehabilitation on severe to moderate COVID-19 patients. 25 discharged COVID-19 patients underwent a cardio-pulmonary test (CPET), a spirometry test and a measure of carbon monoxide lung diffusion capacity (DLCO) at the beginning of their rehabilitation program and after 23 ± 5 rehabilitation sessions. This rehabilitation program combined interval training exercises on a bike and resistance exercises for major muscle groups. We then compared their progress in rehabilitation to that obtained with cardiac patients. At the beginning of their rehabilitation program, COVID-19 patients presented a reduced physical capacity with a maximal aerobic capacity (VO₂ max) at 71% of predicted value, a maximal workload at 70% of predicted value and an exercise hyperventilation measured by a higher VE/VCO₂ slope. Exercise was mainly limited by muscle deconditioning. After rehabilitation, the VO₂ max and maximal workload increased in COVID 19 patients by 18% and 26%, respectively. In patients with ischemic heart disease the post-rehabilitation gains in VO2 max and maximal workload were 22% and 25%, respectively. Moreover, exercise hyperventilation decreased by 10% in both groups. On the other hand, the intrinsic pulmonary function of COVID 19 patients improved following natural recovery. In conclusion, even if cardio-pulmonary rehabilitation is probably not the only parameter which explains the partial recovery of moderate to severe COVID-19 patients, it certainly helps to improve their physical capacity and reduce exercise hyperventilation. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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11 pages, 267 KiB

Open AccessArticle

Efficacy of Nasal High-Flow Oxygen Therapy in Chronic Obstructive Pulmonary Disease Patients in Long-Term Oxygen and Nocturnal Non-Invasive Ventilation during Exercise Training

by Valeria Volpi, Eleonora Volpato, Elena Compalati, Marius Lebret, Giuseppe Russo, Salvatore Sciurello, Gabriele Pappacoda, Antonello Nicolini and Paolo Banfi

Healthcare 2022, 10(10), 2001; https://doi.org/10.3390/healthcare10102001 - 11 Oct 2022

Cited by 2 | Viewed by 1718

Abstract

High-flow oxygen therapy (HFOT) improves gas exchange and dead space washout and reduces the level of work required for breathing. This study aimed to evaluate pulmonary rehabilitation (PR) combined with HFOT in COPD patients treated with nocturnal non-invasive ventilation (NIV) and long-term oxygen [...] Read more.

High-flow oxygen therapy (HFOT) improves gas exchange and dead space washout and reduces the level of work required for breathing. This study aimed to evaluate pulmonary rehabilitation (PR) combined with HFOT in COPD patients treated with nocturnal non-invasive ventilation (NIV) and long-term oxygen therapy (LTOT). In particular, we sought to discover whether the addition of HFOT during exercise training could improve patients’ performance, mainly with regard to their Six-Minute Walking Test (6MWT) outcomes, and reduce the exacerbation rates, periods of rehospitalization or need to resort to unscheduled visits. Thirty-one COPD subjects (13 female) who used nocturnal NIV were included in a randomized controlled trial and allocated to one of two groups: the experimental group (EG), with 15 subjects, subjected to PR with HFOT; and the control group (CG), with 16 subjects, subjected to PR without HFOT. The primary outcome of the study was the observation of changes in the 6MWT. The secondary outcome of the study was related to the rate of exacerbation and hospitalization. Data were collected at baseline and after one, two and three cycles of cycle-ergometer exercise training performed in 20 supervised sessions of 40 min thrice per week, with a washout period of 3 months between each rehabilitation cycle. Statistical significance was not found for the 6MWT distance (W = 0.974; p = 0.672) at the last follow-up, but statistical significance was found for the Borg scale in regard to dyspnea (W = 2.50; p < 0.001) and fatigue (W = 2.00; p < 0.001). HFOT may offer a positive option for dyspnea-affected COPD patients in the context of LTOT and nocturnal NIV. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

12 pages, 1701 KiB

Open AccessArticle

Detailed Changes in Oxygenation following Awake Prone Positioning for Non-Intubated Patients with COVID-19 and Hypoxemic Respiratory Failure—A Historical Cohort Study

by Tomotaka Koike, Nobuaki Hamazaki, Masayuki Kuroiwa, Kentaro Kamiya, Tomohisa Otsuka, Kosuke Sugimura, Yoshiyuki Nishizawa, Mayuko Sakai, Kazumasa Miida, Atsuhiko Matsunaga and Masayasu Arai

Healthcare 2022, 10(6), 1006; https://doi.org/10.3390/healthcare10061006 - 29 May 2022

Cited by 2 | Viewed by 1634

Abstract

Few studies have reported on the effectiveness of awake prone therapy in the clinical course of coronavirus disease (COVID-19) patients. This study aimed to investigate the effects of awake prone therapy during spontaneous breathing on the improvement of oxygenation over 3 weeks for [...] Read more.

Few studies have reported on the effectiveness of awake prone therapy in the clinical course of coronavirus disease (COVID-19) patients. This study aimed to investigate the effects of awake prone therapy during spontaneous breathing on the improvement of oxygenation over 3 weeks for COVID-19 acute respiratory failure. Data of consecutive COVID-19 patients with lung disorder with a fraction of inspired oxygen (F_IO₂) ≥ 0.4 and without tracheal intubation were analyzed. We examined changes in SpO₂/F_IO₂, ROX index ((SpO₂/F_IO₂)/respiratory rate) and the seven-category ordinal scale after the initiation of F_IO₂ ≥ 0.4 and compared these changes between patients who did and did not receive prone therapy. Of 58 patients, 27 received awake prone therapy, while 31 did not. Trend relationships between time course and change in SpO₂/F_IO₂ and ROX index were observed in both groups, although a significant interaction in the relationship was noted between prone therapy and change in SpO₂/F_IO₂ and ROX index. The seven-category ordinal scale also revealed a trend relationship with time course in the prone therapy group. The awake prone therapy was significantly associated with a lower rate of tracheal intubation. In patients with COVID-19 pneumonia treated with F_IO₂ ≥ 0.4, awake prone therapy may improve oxygenation within two weeks. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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11 pages, 1816 KiB

Open AccessEditor’s ChoiceArticle

Efficacy of Early and Enhanced Respiratory Physiotherapy and Mobilization after On-Pump Cardiac Surgery: A Prospective Randomized Controlled Trial

by Georgios Afxonidis, Dimitrios V. Moysidis, Andreas S. Papazoglou, Christos Tsagkaris, Anna Loudovikou, Georgios Tagarakis, Georgios T. Karapanagiotidis, Ioannis A. Alexiou, Christophoros Foroulis and Kyriakos Anastasiadis

Healthcare 2021, 9(12), 1735; https://doi.org/10.3390/healthcare9121735 - 15 Dec 2021

Cited by 7 | Viewed by 4614

Abstract

Background: This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation. Methods: 78 patients undergoing coronary artery bypass graft (CABG) [...] Read more.

Background: This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation. Methods: 78 patients undergoing coronary artery bypass graft (CABG) or/and valvular heart disease surgeries were randomly assigned into an early and enhanced physiotherapy care group (EEPC group; n = 39) and a conventional physiotherapy care group (CPC group; n = 39). Treatment protocol for the EEPC group included ≤3 Mets of physical activity and respiratory physiotherapy on zero post-operative day and an extra physiotherapy session during the first three post-operative days, whereas the CPC group was treated with usual physiotherapy care after the first post-operative day. The length of hospital and intensive care unit (ICU) stay were set as the primary study outcomes, while pre- and post-intervention measurements were also performed to assess the oxymetric and hemodynamic influence of early mobilization and physiotherapy. Results: Participants’ mean age was 51.9 ± 13.8 years. Of them 48 (61.5%) underwent CABG. Baseline and peri-procedural characteristics did not differ between the two groups. The total duration of hospital and ICU stay were significantly higher in the CPC group compared to the EEPC group (8.1 ± 0.4 days versus 8.9 ± 0.6 days and 25.4 ± 3 h versus 23.2 ± 0.6 h, p < 0.001, respectively). Statistically significant differences in pre-intervention oxygen saturation, and post-intervention PO2 and lactate levels were also observed between the two groups (p = 0.022, 0.027 and 0.001, respectively). Conclusion: In on-pump cardiac surgery, early and enhanced post-procedural physical activity (≤3 METS) can prevent a prolonged ICU stay and decrease the duration of hospitalization while ameliorating post-operative hemodynamic and oxymetric parameters. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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12 pages, 1231 KiB

Open AccessSystematic Review

Effects of Exercise Training on Peripheral Muscle Strength in Children and Adolescents with Cystic Fibrosis: A Meta-Analysis

by Anna Thorel, Margaux Machefert, Timothée Gillot, Francis-Edouard Gravier, Tristan Bonnevie, Pascal Le Roux, Clément Medrinal, Guillaume Prieur and Yann Combret

Healthcare 2022, 10(12), 2520; https://doi.org/10.3390/healthcare10122520 - 13 Dec 2022

Viewed by 1484

Abstract

Background: Exercise training is a cornerstone of care for people with cystic fibrosis (pwCF); it improves exercise capacity and health-related physical fitness, but no meta-analysis has investigated its effects on muscle function in young pwCF. The objective of this meta-analysis was to assess [...] Read more.

Background: Exercise training is a cornerstone of care for people with cystic fibrosis (pwCF); it improves exercise capacity and health-related physical fitness, but no meta-analysis has investigated its effects on muscle function in young pwCF. The objective of this meta-analysis was to assess the effects of exercise on peripheral muscle strength in young pwCF. Methods: An electronic search was conducted in four databases (Pubmed, Science Direct, CENTRAL, and PEDRO) from their inception to July 2022. Grey literature databases (OpenGrey, the European Respiratory Society, the American Thoracic Society, and the European Cystic Fibrosis Society) were also consulted. Randomized controlled trials comparing any type of exercise with standard care in young pwCF (5 to 19 years old) were included. Two authors independently selected the relevant studies, extracted the data, assessed the risk of bias (using the Rob2 tool), and rated the quality of the evidence. Results: Ten studies met the inclusion criteria, involving 359 pwCF. Exercise training improved both lower and upper limb muscle strength (SMD 1.67 (95%CI 0.80 to 2.53), I² = 76%, p < 0.001 and SMD 1.30 (95%CI 0.66 to 1.93), I² = 62%, p < 0.001, respectively). Improvements were also reported in muscle mass and maximal oxygen consumption. Results regarding physical activity levels were inconclusive. The overall risk of bias for the primary outcome was high. Conclusions: Exercise training may have a positive effect on peripheral muscle strength in young pwCF. The evidence quality is very low and the level of certainty is poor. There is a need for high-quality randomized controlled studies to confirm these results. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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6 pages, 808 KiB

Open AccessBrief Report

Performance Evaluation of a Low-Cost Non-Invasive Ventilator during the COVID-19 Pandemic: A Bench Study

by Nils Correvon, Jean-Bernard Michotte and Olivier Contal

Healthcare 2022, 10(11), 2229; https://doi.org/10.3390/healthcare10112229 - 07 Nov 2022

Viewed by 1144

Abstract

Background: During the COVID-19 breakout, a global call for low-cost portable ventilators was made following the strong demand for ventilatory support techniques. Among a few development projects, COVIDair non-invasive ventilator was developed and produced in a record time during the critical period of [...] Read more.

Background: During the COVID-19 breakout, a global call for low-cost portable ventilators was made following the strong demand for ventilatory support techniques. Among a few development projects, COVIDair non-invasive ventilator was developed and produced in a record time during the critical period of spring 2020. Objectives: To evaluate COVIDair performance (i.e., inspiratory trigger delay time, TDT, pressurization time and inspiratory to expiratory time ratio, I:E) on a test bench simulating physiological characteristics of breathing. Method: Performance tests were conducted on a breathing simulator (ASL 5000, IngMar Medical™) in two different lung mechanics (i.e., normal and severe restrictive). Results: Under normal pulmonary mechanics, the inspiratory TDT is on average between 89.0 (±2.1) and 135.0 (±9.7) ms. In a situation of severe restrictive pulmonary mechanics, the inspiratory TDT is on average between 80 (±3.1) and 99.2 (±5.5) ms. Pressurization time to pre-set inspiratory pressure was on average from 234.6 (±5.5) to 318.6 (±1.9) ms. The absolute difference between the actual I:E cycling measure and the pre-set I:E cycling value ranged from 0.1 to 10.7% on average. Conclusion: In normal and severe restrictive pulmonary mechanics scenarios, the performance of COVIDair meets the expected standards for non-invasive ventilators. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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19 pages, 845 KiB

Open AccessSystematic Review

Telerehabilitation as a Form of Pulmonary Rehabilitation in Chronic Lung Disease: A Systematic Review

by Gregory Reychler, Elise Piraux, Marc Beaumont, Gilles Caty and Giuseppe Liistro

Healthcare 2022, 10(9), 1795; https://doi.org/10.3390/healthcare10091795 - 17 Sep 2022

Cited by 5 | Viewed by 2203

Abstract

Introduction: Tele-rehabilitation is increasingly used to deliver pulmonary rehabilitation. The aim of this systematic review was to compare the effect between tele-pulmonary rehabilitation and classical supervised pulmonary rehabilitation. Method: Three databases were analysed (PubMed, PEDro, Scopus). The selection and evaluation of studies followed [...] Read more.

Introduction: Tele-rehabilitation is increasingly used to deliver pulmonary rehabilitation. The aim of this systematic review was to compare the effect between tele-pulmonary rehabilitation and classical supervised pulmonary rehabilitation. Method: Three databases were analysed (PubMed, PEDro, Scopus). The selection and evaluation of studies followed the PRISMA guidelines. The risk of bias was evaluated using the PEDro Scale. Results: From the initial selection (n = 245), ten studies were retrieved, including from 10 to 67 patients. All but two (IPF) included patients with COPD. Based on the FEV1, patients with COPD were mainly categorised as moderate and severe. The teleactivities were heterogenous in terms of proposed exercises and way of settings and often not in agreement with the guidelines about pulmonary rehabilitation. Despite this, the effects of the interventions were globally positive on functional exercise capacity, quality of life, anxiety and depression, and impact of COPD on personal life but not on dyspnoea. The PEDro scores varied from 4 to 8. The adherence was higher than 80% when supervision during the exercise was included. Conclusion: This review demonstrated that the telerehabilitation is safe and well accepted by the patients, and could be considered as one option of classical pulmonary rehabilitation to improve the functional exercise capacity, quality of life, anxiety and depression, and the impact of COPD on personal’s life. This conclusion cannot be extrapolated to the other chronic lung diseases due to the lack of data. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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15 pages, 2053 KiB

Open AccessSystematic Review

Isolated Resistance Training Programs to Improve Peripheral Muscle Function in Outpatients with Chronic Obstructive Pulmonary Diseases: A Systematic Review

by Simone Pancera, Nicola F. Lopomo, Luca N. C. Bianchi, Paolo Pedersini and Jorge H. Villafañe

Healthcare 2021, 9(10), 1397; https://doi.org/10.3390/healthcare9101397 - 19 Oct 2021

Cited by 6 | Viewed by 2046

Abstract

This systematic review aims to establish which isolated resistance training (RT) programs have been used in outpatients with chronic obstructive pulmonary disease (COPD) and their impact on all aspects of peripheral skeletal muscle function. Electronic databases were systematically searched up to June 2021. [...] Read more.

This systematic review aims to establish which isolated resistance training (RT) programs have been used in outpatients with chronic obstructive pulmonary disease (COPD) and their impact on all aspects of peripheral skeletal muscle function. Electronic databases were systematically searched up to June 2021. The eligibility criteria were: (1) randomized controlled trials investigating the effects of supervised and isolated RT programs in outpatients with COPD and (2) RT programs lasting 8–12 weeks, (3) including at least one outcome measure related to trainable muscle characteristics. Initially, 6576 studies were identified, whereas 15 trials met the inclusion criteria. All the included trials reported that isolated RT improved both upper and lower limbs’ maximal strength. Muscle endurance and power also increased after RT but received less attention in the analysis. Furthermore, few studies assessed the effect of RT on muscle mass and cross-sectional area, reporting only limited improvement. Isolated RT programs carried out 2–3 days a week for 8–12 weeks improved skeletal muscle function in individuals with COPD. The RT program should be specifically focused to the trainable muscle characteristic to be improved. For this reason, we further encourage the introduction of a detailed assessment of muscle function and structure during the pulmonary rehabilitation practice. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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