25 results on '"Brooks Dina"'
Search Results
2. COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time
- Author
-
Marques, Alda, Souto-Miranda, Sara, Machado, Ana, Oliveira, Ana, Jácome, Cristina, Cruz, Joana, Enes, Vera, Afreixo, Vera, Martins, Vitória, Andrade, Lília, Valente, Carla, Ferreira, Diva, Simão, Paula, Brooks, Dina, and Tavares, Ana Helena
- Published
- 2022
- Full Text
- View/download PDF
3. Pulmonary rehabilitation with balance training for fall reduction in chronic obstructive pulmonary disease: a randomized controlled trial.
- Author
-
Hao, Qiukui, Brooks, Dina, Ellerton, Cindy, Goldstein, Roger, Lee, Annemarie L., Alison, Jennifer A., Dechman, Gail, Haines, Kimberley J., Harrison, Samantha L., Holland, Anne E., Marques, Alda, Spencer, Lissa, Stickland, Michael K., Skinner, Elizabeth H., Camp, Pat G., Ma, Jinhui, and Beauchamp, Marla K.
- Subjects
CHRONIC obstructive pulmonary disease ,EXERCISE therapy ,ACCIDENTAL falls ,RANDOMIZED controlled trials ,PHYSICAL therapy - Abstract
Background and objectives: Available evidence suggests that adults with chronic obstructive pulmonary disease (COPD) performed substantially worse than healthy controls on many balance measures and balance training can improve the balance measures in this population. We conducted this study to determine the effects of incorporating balance training into pulmonary rehabilitation (PR) on the incidence of falls at 12 months follow-up in high fall risk adults with COPD. Methods: We conducted a prospective international multi-center randomized controlled trial. Eligible participants were adults with COPD at a high risk of future falls and were randomly assigned (1:1) to the intervention or control group. The intervention included personalized balance training for a targeted total of 90 min per week. Both the intervention and control groups received usual PR (2–3 times per week for 8–12 weeks). The primary outcome was the incidence of falls at 12-month follow-up using monthly fall diary calendars. Negative binomial regression or recurrent events models were used to examine the effects of the intervention on fall events. Multiple imputations were performed to deal with missing values. Results: Of 258 participants who were enrolled in the trial, 178 provided falls information (intervention group = 91, control group = 87) and were included in the main analysis. Forty-one participants (45%) experienced at least one fall event in the intervention group and 33 (38%) in the control group (p = 0.34). The mean incidence of falls at 12 months was similar between the two groups (128 versus 128 per 100 person-years; mean difference: 0.30, 95% CI: -0.76 to 1.36 per 100 person-years). The results are robust after multiple imputations for missing data (n = 67). Conclusions: PR incorporating balance training compared to PR alone did not reduce the incidence of falls over the 12-month period in high fall risk adults with COPD. Trial registration: The study was registered with ClinicalTrials.gov (NCT02995681) on 14/12/2016. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in individuals with stable chronic obstructive pulmonary disease (COPD): a systematic review.
- Author
-
Nikolovski, Aleksandra, Gamgoum, Lara, Deol, Arshpreet, Quilichini, Shea, Kazemir, Ethan, Rhodenizer, Jonathan, Oliveira, Ana, Brooks, Dina, and Alsubheen, Sanaa
- Subjects
MEDICAL information storage & retrieval systems ,WORLD Wide Web ,RESEARCH evaluation ,ANXIETY ,DESCRIPTIVE statistics ,CHRONIC diseases ,MEDLINE ,PSYCHOMETRICS ,OBSTRUCTIVE lung diseases ,PSYCHOLOGICAL tests ,MENTAL depression ,PSYCHOLOGY information storage & retrieval systems - Abstract
The Hospital Anxiety and Depression Scale (HADS) is used to assess anxiety and depression in individuals with chronic obstructive pulmonary disease (COPD); however, its measurement properties lack critical appraisal. We aimed to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in COPD. Five electronic databases were searched. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines were used to assess the methodological and evidence quality in the selected studies. Twelve studies assessed the psychometric properties of the HADS-Total and its subscales HADS-Anxiety and HADS-Depression in COPD. High-quality evidence supported the structural and criterion validity of the HADS-A, the internal consistency of the HADS-T, HADS-A, and HADS-D with Cronbach's alpha values of 0.73–0.87, and before–after treatment responsiveness of HADS-T and its subscales (minimal clinically important difference = 1.4–2; effect size = 0.45–1.40). Moderate-quality evidence supported the test–retest reliability of the HADS-A and HADS-D with excellent coefficient values of 0.86–0.90. The HADS-A is recommended for use in individuals with stable COPD. The lack of high-quality evidence on the validity of the HADS-D and HADS-T prevented drawing robust conclusions about their clinical utility in COPD. Anxiety and depression are common in individuals with chronic obstructive pulmonary disease (COPD). Anxiety and depression can negatively impact the physical and mental health of individuals with COPD. The HADS can be used to assess anxiety and depression in COPD in rehabilitation settings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. Assessing caregiving experience in COPD: content validity of the Zarit Burden Interview in Canadian and Portuguese caregivers.
- Author
-
Selzler, Anne-Marie, Brooks, Dina, Marques, Alda, Souto-Miranda, Sara, Goldstein, Roger, and Cruz, Joana
- Subjects
- *
CAREGIVER attitudes , *INFERENTIAL statistics , *RESEARCH methodology evaluation , *PORTUGUESE people , *RESEARCH methodology , *BURDEN of care , *ACQUISITION of data , *INTERVIEWING , *EXPERIENCE , *T-test (Statistics) , *PSYCHOMETRICS , *OBSTRUCTIVE lung diseases , *PSYCHOLOGY of caregivers , *QUESTIONNAIRES , *RESEARCH funding , *DESCRIPTIVE statistics , *MEDICAL records , *CHI-squared test , *CONTENT analysis ,RESEARCH evaluation - Abstract
Informal caregivers play an important role in chronic disease management but their experience is often neglected. The objective of this study was to explore the content validity of the Zarit Burden Interview (ZBI) in caregivers of individuals with COPD in Canada and Portugal. Cognitive debriefing interviews were conducted with informal caregivers of individuals with moderate to very severe COPD. Participants completed the ZBI and verbalised their thinking process to assess the adequacy of the questionnaire's content and instructions. Content validity was assessed using deductive content analysis of interviews and descriptive statistics of questionnaire responses. Nine caregivers from Canada (age = 67 ± 8 years) and 13 from Portugal (age = 69 ± 7 years) participated. For Canadian caregivers, 3/22 items were not understood, and 8/22 items were not relevant to at least 1/3 of them. For Portuguese caregivers, 1/22 items were not understood, and 20/22 items were not relevant to at least 1/3 of them. The distribution of response choices was approximately symmetrical for 17/22 items in the Canadian sample. The response option "no/never" was selected by at least 75% of Portuguese participants for 18/22 items. The instrument was well understood by caregivers of people with COPD, but its relevance is uncertain. Informal caregivers provide essential care for people living with disability and chronic disease, but their experience is often neglected. The Zarit Burden Interview assesses caregiver burden but has not been validated in caregivers of people with chronic obstructive pulmonary disease. In its current form, the Zarit Burden Interview does not adequately represent the experience of COPD caregivers. We recommend selecting tools that assess caregiver burden that have been validated in the caregiver population of interest. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
6. Occupational therapy in pulmonary rehabilitation programs: a scoping review protocol
- Author
-
Snyder, Natalie, Wilson, Ria, Finch, Lian, Frankel, Daniel, Gallant, Brooklyn, Landa, Chris, Packham, Tara, Brooks, Dina, and Oliveira, Ana
- Subjects
Pulmonary rehabilitation ,Rehabilitation and Therapy ,Respiratory Therapy ,Occupational Therapy ,Chronic lung disease ,Rehabilitation ,Respiratory rehabiltation ,Medicine and Health Sciences ,COPD ,Other Rehabilitation and Therapy - Abstract
People with chronic respiratory diseases present several physical, psychological and social impairments that contribute to decrease their ability to perform activities of daily living and compromise their independence. Occupational therapy (OT) has been designated as part of the rehabilitation process for disabled individuals with the aim of providing them maximal function and independence to sustain activities of daily living and to improve their ability to cope with working and social behaviours. Thus, OT is strictly linked with the individual’s autonomy, both to manage deficient activities and prevent any further deterioration. Pulmonary rehabilitation (PR) is currently a core component of the management of people with chronic respiratory diseases. While it is widely accepted that PR should be implemented by an interdisciplinary team, less than 40% of PR programs in Canada report having an OT in the team and it is not clear from national and international reports and guidelines what their role and their added value to patients’ outcomes. Thus, the aims of this scoping review is to explore the role of occupational therapy (OT) in pulmonary rehabilitation (PR) programs, the current guidelines for including OT in PR programs, and the estimated prevalence and reported or anticipated effects of OT interventions in PR programs.
- Published
- 2022
- Full Text
- View/download PDF
7. Age and Sex Differences in Balance Outcomes among Individuals with Chronic Obstructive Pulmonary Disease (COPD) at Risk of Falls.
- Author
-
Alsubheen, Sanaa A., Beauchamp, Marla, Ellerton, Cindy, Goldstein, Roger, Alison, Jennifer, Dechman, Gail, Haines, Kimberley J., Harrison, Samantha, Holland, Anne, Lee, Annemarie, Marques, Alda, Spencer, Lissa, Stickland, Michael, Skinner, Elizabeth H., and Brooks, Dina
- Subjects
CHRONIC obstructive pulmonary disease ,AGE differences ,OLDER people - Abstract
No previous research has examined age and sex differences in balance outcomes in individuals with chronic obstructive pulmonary disease (COPD) at risk of falls. A secondary analysis of baseline data from an ongoing trial of fall prevention in COPD was conducted. Age and sex differences were analyzed for the Berg Balance scale (BBS), Balance Evaluation System Test (BEST test) and Activities-specific Balance Confidence Scale (ABC). Overall, 223 individuals with COPD were included. Females had higher balance impairments than males [BBS: mean (SD) = 47 (8) vs. 49 (6) points; BEST test: 73 (16) vs. 80 (16) points], and a lower confidence to perform functional activities [ABC = 66 (21) vs. 77 (19)]. Compared to a younger age (50–65 years) group, age >65 years was moderately associated with poor balance control [BBS (r = − 0.37), BEST test (r = − 0.33)] and weakly with the ABC scale (r = − 0.13). After controlling for the effect of balance risk factors, age, baseline dyspnea index (BDI), and the 6-min walk test (6-MWT) explained 38% of the variability in the BBS; age, sex, BDI, and 6-MWT explained 40% of the variability in the BEST test; And BDI and the 6-MWT explained 44% of the variability in the ABC scale. This study highlights age and sex differences in balance outcomes among individuals with COPD at risk of falls. Recognition of these differences has implications for pulmonary rehabilitation and fall prevention in COPD, particularly among females and older adults. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
8. Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
- Author
-
Nonoyama, Mika L, Kin, Susan Marzolini R, Brooks, Dina, and Oh, Paul
- Subjects
Smokers ,Cardiac rehabilitation ,COPD ,Original Article ,Aerobic execise ,Comorbidities - Abstract
Although currently major contributors to morbidity and mortality, cardiovascular disease (CVD) and chronic respiratory diseases, such as chronic obstructive pulmonary disease, are projected to rank among the top three in global disease burden by 2020. Multimorbidity is a common feature in CVD and chronic respiratory disease, and patients often share the same pathological characteristics including anatomical location of disease, dyspnea and fatigue, among several others. However, patients entering rehabilitation programs for either condition are functionally diverse; therefore, individuals with respiratory comorbidities may not fare as well in cardiac rehabilitation programs. This retrospective cohort study investigated several relevant functional parameters and outcomes., OBJECTIVE: To describe the prevalence and impact of respiratory comorbidities on patients undergoing cardiac rehabilitation (CR). METHODS: A retrospective review of a CR database (1999 to 2004) of patients with ischemic heart disease with ≥10 pack per year (ppy) smoking history and respiratory comorbidities (RC), non-respiratory comorbidities (NRC) and no comorbidities (NC) was performed. Primary outcomes at zero, six and 12 months included peak oxygen uptake (VO2peak), maximum workload, resting heart rate, ventilatory anaerobic threshold and anthropometrics. Analyses were performed on individuals who completed the program, adjusting for age, sex and baseline VO2peak. RESULTS: Of 5922 patients, 1247 had ≥10 ppy smoking history: 77 (6.2%) had RC; 957 (76.7%) had NRC; and 213 (17.1%) had NC. The program completion rate for each group was similar for the RC (46.8%), NRC (55.8%) and NC groups (57.3%) (P=0.26). The RC group had the lowest baseline fitness levels (P
- Published
- 2016
9. Relação entre a atividade física e o distress associado à sobrecarga em cuidadores informais de indivíduos com DPOC
- Author
-
Ruivo, Adriana, Hipólito, Nádia, Martins, Sara, Marques, Alda, Brooks, Dina, Silva, Cândida G., and Cruz, Joana
- Subjects
Informal caregiver ,Physical activity ,Distress ,COPD ,Burden - Abstract
Introdução: A doença pulmonar obstrutiva crónica (DPOC) é uma condição que pode levar ao aumento da dependência do doente em relação ao cuidador informal e, consequentemente, promover um aumento do distress associado à sobrecarga deste.1 De acordo com a literatura, na população geral, maiores níveis de atividade física (AF) contribuem para menores níveis de distress2. O objetivo principal deste estudo foi verificar se esta relação se confirma em cuidadores informais de pessoas com DPOC. Metodologia: Foi desenvolvido um estudo observacional transversal, tendo-se realizado a caracterização sociodemográfica da amostra, a recolha de informação sobre o contexto de prestação de cuidados e a aplicação dos questionários: Questionário de Avaliação de Sobrecarga do Cuidador Informal (QASCI), para avaliar o nível de distress associado à sobrecarga, e Habitual Physical Activity Questionnaire (HPAQ), para avaliar o nível de AF. Para a análise de dados foram utilizadas medidas de estatística descritiva, os coeficientes de correlação Pearson e Spearman e regressões lineares (simples e múltiplas). Resultados: Foram incluídos 26 cuidadores (63,1 ± 9,7 anos; 84,6% feminino e 15,4% masculino). A média do QASCI foi de 31,3 ± 22 e a do HPAQ foi de 5,5 ± 1,8. A correlação entre estas variáveis foi moderada negativa (r=-0,535, p=0.01). A variável AF teve a capacidade de predizer o valor do QASCI em 28,7%. Ao adicionar a variável duração de cuidados em anos, foi possível aumentar para 54,6% a capacidade de a equação predizer o valor do QASCI. Conclusões: Os resultados sugerem que existe uma relação entre o aumento do nível da AF e a diminuição do nível de distress nesta população. Estes achados suportam a importância da promoção da prática de AF nos cuidadores informais de indivíduos com DPOC. Estudos longitudinais futuros deverão ser considerados. N/A
- Published
- 2018
10. Psychometric Properties of Patient-Reported Outcome Measures Assessing Self-Efficacy in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review.
- Author
-
Alsubheen, Sanaa A., Wshah, Adnan, Goldstein, Roger, and Brooks, Dina
- Subjects
PSYCHOMETRICS ,PATIENT reported outcome measures ,OBSTRUCTIVE lung diseases ,SELF-efficacy ,CRONBACH'S alpha - Abstract
This systematic review aimed to synthesize the evidence of the psychometric properties of self-efficacy patient-reported outcome measures (PROMs) in patients with chronic obstructive pulmonary disease (COPD). We conducted a systematic search of MEDLINE and other common databases from inception until September 2020. Studies that reported psychometric properties of self-efficacy outcome measures in COPD patients were included. We used the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) 2018 guidelines for data extraction and evidence synthesis. Eighteen studies that assessed nine self-efficacy PROMs were eligible for inclusion. The assessment of structural validity indicated sufficient results rating for the Exercise Self-Regulatory Efficacy Scale and the Self-Care-Self-Efficacy Scale, and insufficient rating for the COPD Self-Efficacy Scale and the Pulmonary Rehabilitation Adaptation Index for Self-Efficacy (PRAISE). Construct validity measures displayed sufficient results rating with correlations ranging from −0.48 to − 0.71 between self-efficacy PROMs and other PROMs such as St. George's Respiratory Questionnaire, Hospital Anxiety and Depression Scale and Chronic Respiratory Questionnaire. Internal consistency measures indicated sufficient rating for all self-efficacy PROMs with a Cronbach's alpha range of 0.71 − 0.98. Responsiveness was assessed for the PRAISE with an overall sufficient rating (effect sizes of 0.21 − 0.37). The evidence regarding the psychometric properties of self-efficacy PROMs in COPD is variable. The PRAISE is responsive to changes in self-efficacy in COPD patients attending a pulmonary rehabilitation program. When using self-efficacy PROMs in clinical practice or research, clinicians and researchers should consider the psychometric properties and choose the appropriate outcome measure based on the purpose. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
11. Pulmonary Rehabilitation With Balance Training for Fall Reduction in Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Controlled Trial
- Author
-
Beauchamp, Marla K, Brooks, Dina, Ellerton, Cindy, Lee, Annemarie, Alison, Jennifer, Camp, Pat G, Dechman, Gail, Haines, Kimberley, Harrison, Samantha L, Holland, Anne E, Marques, Alda, Moineddin, Rahim, Skinner, Elizabeth H, Spencer, Lissa, Stickland, Michael K, Xie, Feng, and Goldstein, Roger S
- Subjects
Balance ,medicine.medical_specialty ,medicine.medical_treatment ,economic analysis ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intervention (counseling) ,falls ,Health care ,Protocol ,COPD ,Medicine ,Pulmonary rehabilitation ,030212 general & internal medicine ,Exercise ,Health policy ,Balance (ability) ,exercise ,business.industry ,Economic analysis ,balance ,General Medicine ,medicine.disease ,pulmonary rehabilitation ,3. Good health ,030228 respiratory system ,Physical therapy ,Falls ,business ,Fall prevention - Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. A growing body of evidence shows that individuals with COPD have important deficits in balance control that may be associated with an increased risk of falls. Pulmonary rehabilitation (PR) is a key therapeutic intervention for individuals with COPD; however, current international guidelines do not include balance training and fall prevention strategies. Objective: The primary aim of this trial is to determine the effects of PR with balance training compared to PR with no balance training on the 12-month rate of falls in individuals with COPD. Secondary aims are to determine the effects of the intervention on balance, balance confidence, and functional lower body strength, and to estimate the cost-effectiveness of the program. Methods: A total of 400 individuals from nine PR centers across Canada, Europe, and Australia will be recruited to participate in a randomized controlled trial. Individuals with COPD who have a self-reported decline in balance, a fall in the last 2 years, or recent near fall will be randomly assigned to an intervention or control group. The intervention group will undergo tailored balance training in addition to PR and will receive a personalized home-based balance program. The control group will receive usual PR and a home program that does not include balance training. All participants will receive monthly phone calls to provide support and collect health care utilization and loss of productivity data. Both groups will receive home visits at 3, 6, and 9 months to ensure proper technique and progression of home exercise programs. The primary outcome will be incidence of falls at 12-month follow-up. Falls will be measured using a standardized definition and recorded using monthly self-report fall diary calendars. Participants will be asked to record falls and time spent performing their home exercise program on the fall diary calendars. Completed calendars will be returned to the research centers in prepaid envelopes each month. Secondary measures collected by a blinded assessor at baseline (pre-PR), post-PR, and 12-month follow-up will include clinical measures of balance, balance confidence, functional lower body strength, and health status. The cost-effectiveness of the intervention group compared with the control group will be evaluated using the incremental cost per number of falls averted and the incremental cost per quality-adjusted life years gained. Results: Recruitment for the study began in January 2017 and is anticipated to be complete by December 2019. Results are expected to be available in 2020. Conclusions: Findings from this study will improve our understanding of the effectiveness and resource uses of tailored balance training for reducing falls in individuals with COPD. If effective, the intervention represents an opportunity to inform international guidelines and health policy for PR in individuals with COPD who are at risk of falling. Trial Registration: ClinicalTrials.gov NCT02995681; https://clinicaltrials.gov/ct2/show/NCT02995681 (Archived by WebCite at http://www.webcitation.org/6ukhxgAsg) [JMIR Res Protoc 2017;6(11):e228]
- Published
- 2017
12. Comparing the impact of different exercise interventions on fatigue in individuals with COPD: A systematic review and meta-analysis.
- Author
-
Li, Lok Sze Katrina, Butler, Stacey, Goldstein, Roger, and Brooks, Dina
- Abstract
To systematically review randomized controlled trials that compared the effectiveness of different types of exercise on the symptom of fatigue in individuals with chronic obstructive pulmonary disease (COPD). MEDLINE, EMBASE, EMcare, PsychINFO, and Cochrane library were searched from inception to October 2018. Studies were included if individuals with COPD were randomized into two or more physical exercise interventions that reported fatigue. Of the 395 full-texts reviewed, 17 studies were included. Fifteen studies reported the impact of exercise on health-related quality of life with fatigue as a subdomain. Reduction in fatigue was observed following endurance, resistance, or a combination of both exercises. There was no significant difference between continuous and interval training (n = 3 studies, pooled standardized mean difference (SMD) = -0.17, 95% CI = -0.47, 0.12, p = 0.25) or between endurance and resistance training (n = 3 studies, SMD = -0.35, 95% CI = -0.72, 0.01, p = 0.07) on fatigue in people with COPD. Fatigue reduction is not usually a primary outcome of exercise interventions, but it is frequently a secondary domain. The type of exercise did not influence the impact of exercise on fatigue, which was reduced in endurance, resistance, or a combination of both exercises, enabling clinicians to personalize training to match targeted outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
13. The Impact of Listening to Music During a High-Intensity Exercise Endurance Test in People With COPD.
- Author
-
Lee, Annemarie L., Dolmage, Thomas E., Rhim, Matthew, Goldstein, Roger S., Brooks, Dina, and Goldstein, Roger
- Subjects
OBSTRUCTIVE lung diseases patients ,DYSPNEA ,EXERCISE tolerance ,PHYSIOLOGICAL effects of music ,HEART beat - Abstract
Background: In people with COPD, dyspnea is the primary symptom limiting exercise tolerance. One approach to reducing dyspnea during exercise is through music listening. A constant speed endurance test reflects a high-intensity aerobic exercise training session, but whether listening to music affects endurance time is unknown. This study aimed to determine the effects of listening to music during a constant speed endurance test in COPD.Methods: Participants with COPD completed two endurance walk tests, one with and one without listening to self-selected music throughout the test. The primary outcome was the difference in endurance time between the two conditions. Heart rate, percutaneous oxygen saturation, dyspnea, and rate of perceived exertion were measured before and after each test.Results: Nineteen participants (mean [SD]: age, 71 [8] years; FEV1, 47 [19] % predicted) completed the study. Endurance time was greater (1.10 [95% CI, 0.41-1.78] min) while listening to music (7.0 [3.1] min) than without (5.9 [2.6] min), and reduced end-test dyspnea (1.0 [95% CI, -2.80 to -1.80] units) (with music, 4.6 [1.7] units; vs without music, 5.6 [1.4] units, respectively). There was not a significant difference in heart rate, percutaneous oxygen saturation, or leg fatigue. There were no adverse events under either condition.Conclusions: In COPD, dyspnea was less while listening to music and was accompanied by an increased tolerance of high-intensity exercise demonstrated by greater endurance time. Practically, the effect was modest but may represent an aid for exercise training of these patients.Trial Registry: Australian New Zealand Clinical Trials Registry; No. ACTRN12617001217392. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
14. “We are all there for the same purpose”: Support for an integrated community exercise program for older adults with HF and COPD.
- Author
-
Desveaux, Laura, Harrison, Samantha, Lee, Annemarie, Mathur, Sunita, Goldstein, Roger, and Brooks, Dina
- Abstract
Background Despite well-established improvements following rehabilitation, functional gains often diminish following discharge. Objective To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance. Methods Semi-structured interviews were conducted with 11 individuals with HF or COPD. Results Deductive thematic analysis uncovered three themes: 1) transitioning to community exercise is challenging, highlighting participants' struggle with unstructured maintenance and a lack of appropriate programs; 2) a structured, group-based program tailored to functional ability facilitates adherence, describing participants views on the importance of routine, and accountability; and 3) “We are all there for the same purpose” – participant support for integrated exercise, including the benefit of multiple perspectives and sustainability. Conclusions A motivating program leader and access to appropriate facilities are key features to support adherence to prescribed activity. Tailored programs can be delivered consecutively to older adults with HF and COPD. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
15. Exploring self-conscious emotions in individuals with chronic obstructive pulmonary disease: A mixed-methods study.
- Author
-
Harrison, Samantha L., Robertson, Noelle, Goldstein, Roger S., and Brooks, Dina
- Abstract
This study aimed to explore the extent to which self-conscious emotions are expressed, to explore any associations with adverse health outcomes, and to compare self-conscious emotions in individuals with chronic obstructive pulmonary disease (COPD) to healthy controls. A two-stage mixed-methods study design was employed. Interviews with 15 individuals with COPD informed the choice of questionnaires to assess self-conscious emotions which were completed by individuals with COPD and healthy controls. Five overarching themes were abstracted: grief, spectrum of blame, concern about the view of others, concealment, and worry about the future. The questionnaires were completed by 70 patients (mean(SD) age 70.8(9.4) years, forced expiratory volume in one second predicted 40.5(18.8), 44% male) and 61 healthy controls (mean(SD) age 62.2(12.9) years, 34% male]. Self-conscious emotions were associated with reduced mastery, heightened emotions, and elevated anxiety and depression (all p < 0.001). Individuals with COPD reported lower self-compassion, higher shame, and less pride than healthy controls (all p ≤ 0.01). There is a need to increase awareness of self-conscious emotions in individuals with COPD. Therapies to target such emotions may improve mastery, emotions, and psychological symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
16. Interpretability of Change Scores in Measures of Balance in People With COPD.
- Author
-
Beauchamp, Marla K., Harrison, Samantha L., Goldstein, Roger S., and Brooks, Dina
- Subjects
OBSTRUCTIVE lung diseases ,LUNG disease diagnosis ,RESPIRATORY diseases ,LUNG radiography ,RESPIRATORY obstructions ,POSTURAL balance ,ACCIDENTAL falls ,HEALTH outcome assessment ,PHARMACOKINETICS ,PHYSICAL therapy ,RESEARCH funding ,RESPIRATORY therapy ,VITAL capacity (Respiration) ,RECEIVER operating characteristic curves - Abstract
Background: Balance deficits and an increased fall risk are well documented in individuals with COPD. Despite evidence that balance training programs can improve performance on clinical balance tests, their minimal clinically important difference (MCID) is unknown. The aim of this study was to determine the MCID of the Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), and Activities-Specific Balance Confidence (ABC) scale in patients with COPD undergoing pulmonary rehabilitation.Methods: We performed a secondary analysis of data from two studies of balance training in COPD (n = 55). The MCID for each balance measure was estimated using the following anchor and distribution-based approaches: (1) mean change scores on a patient-reported global change in balance scale, (2) optimal cut-point from receiver operating characteristic curves (ROCs), and (3) the minimal detectable change with 95% confidence (MDC95).Results: Data from 55 patients with COPD (mean age, 71.2 ± 7.1 y; mean FEV1, 39.2 ± 15.8% predicted) were used in the analysis. The smallest estimate of MCID was from the ROC method. Anchor-based estimates of the MCID ranged from 3.5 to 7.1 for the BBS, 10.2 to 17.4 for the BESTest, and 14.2 to 18.5 for the ABC scale; their MDC95 values were 5.0, 13.1, and 18.9, respectively.Conclusions: Among patients with COPD undergoing pulmonary rehabilitation, a change of 5 to 7 points for the BBS, 13 to 17 points for the BESTest, and 19 points for the ABC scale is required to be both perceptible to patients and beyond measurement error. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
17. Minimizing the evidence-practice gap - a prospective cohort study incorporating balance training into pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease.
- Author
-
Harrison, Samantha L., Beauchamp, Marla K., Sibley, Kathryn, Tamara Araujo, Romano, Julia, Goldstein, Roger S., and Brooks, Dina
- Subjects
OBSTRUCTIVE lung diseases ,MEDICAL rehabilitation ,COHORT analysis ,MEDICAL personnel ,DISEASE prevalence ,SYMPTOMS - Abstract
Background: We have recently demonstrated the efficacy of balance training in addition to Pulmonary Rehabilitation (PR) at improving measures of balance associated with an increased risk of falls in individuals with Chronic Obstructive Pulmonary Disease (COPD). Few knowledge translation (KT) projects have been conducted in rehabilitation settings. The goal of this study was to translate lessons learnt from efficacy studies of balance training into a sustainable clinical service. Methods: Health care professionals (HCPs) responsible for delivering PR were given an hour of instruction on the principles and practical application of balance training and the researchers offered advice regarding; prescription, progression and practical demonstrations during the first week. Balance training was incorporated three times a week into conventional PR programs. Following the program, HCPs participated in a focus group exploring their experiences of delivering balance training alongside PR. Service users completed satisfaction surveys as well as standardized measures of balance control. At six month follow-up, the sustainability of balance training was explored. Results: HCPs considered the training to be effective at improving balance and the support provided by the researchers was viewed as helpful. HCPs identified a number of strategies to facilitate balance training within PR, including; training twice a week, incorporating an interval training program for everyone enrolled in PR, providing visual aids to training and promoting independence by; providing a set program, considering the environment and initiating a home-based exercise program early. Nineteen service users completed the balance training [ten male mean (SD) age 73 (6) y]. Sixteen patients (84 %) enjoyed balance training and reported that it helped them with everyday activities and 18 (95 %) indicated their wish to continue with it. Scores on balance measures improved following PR that included balance training (all p < 0.05). At six month follow-up balance training is being routinely assessed and delivered as part of standardised PR. Conclusions: Implementing balance training into PR programs, with support and training for HCPs, is feasible, effective and sustainable. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
18. An International Comparison of Pulmonary Rehabilitation: A Systematic Review.
- Author
-
Desveaux, Laura, Janaudis-Ferreira, Tania, Goldstein, Roger, and Brooks, Dina
- Subjects
OBSTRUCTIVE lung diseases ,MEDICAL rehabilitation ,OUTPATIENT medical care ,PHYSICAL therapists ,MEDICAL care ,DYSPNEA - Abstract
Background: Despite the strong evidence base, the perception remains that the provision of pulmonary rehabilitation (PR) services are extremely limited. Imbalances in PR delivery give rise to unnecessary health costs and underserviced populations. We conducted a systematic review to characterize the international provision of PR, comparing its structure and delivery across countries, and gaining insight into the availability of PR in relation to geographical prevalence. Methods: Electronic databases were searched from inception to September 2013 using the key words 'pulmonary rehabilitation' and 'survey.' Two authors independently reviewed studies and assessed study quality. Data was extracted and double-checked to ensure accuracy. Results: The majority of programs (55-99%) were offered in an outpatient setting with the exception of Ireland, where the majority of programs were offered in the community (65%). Exercise was the primary component across all programs (77-100%), followed by education (74-100%). Physical therapists were the most common member of the PR team (49-100%). Functional walk tests were the most frequently used outcome measure, although the specific test utilized varied across countries. The current availability of PR services ≤1.2% of individuals with COPD. Conclusion: Components provided in PR are similar, irrespective of country, while patient outcome measures demonstrated variation across countries. Recent surveys report the use of community resources for the delivery of PR programs, although the majority are outpatient based. The small number of potential individuals enrolled in PR suggests that an international increase in access and capacity would improve quality of life and reduce healthcare utilization in this population. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
19. Pulmonary Rehabilitation With Balance Training for Fall Reduction in Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Controlled Trial.
- Author
-
Beauchamp, Marla K., Brooks, Dina, Ellerton, Cindy, Lee, Annemarie, Alison, Jennifer, Camp, Pat G., Dechman, Gail, Haines, Kimberley, Harrison, Samantha L., Holland, Anne E., Marques, Alda, Moineddin, Rahim, Skinner, Elizabeth H., Spencer, Lissa, Stickland, Michael K., Feng Xie, and Goldstein, Roger S.
- Subjects
OBSTRUCTIVE lung diseases ,LUNG diseases ,RISK factors of falling down ,ACCIDENTAL fall prevention ,QUALITY-adjusted life years - Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. A growing body of evidence shows that individuals with COPD have important deficits in balance control that may be associated with an increased risk of falls. Pulmonary rehabilitation (PR) is a key therapeutic intervention for individuals with COPD; however, current international guidelines do not include balance training and fall prevention strategies. Objective: The primary aim of this trial is to determine the effects of PR with balance training compared to PR with no balance training on the 12-month rate of falls in individuals with COPD. Secondary aims are to determine the effects of the intervention on balance, balance confidence, and functional lower body strength, and to estimate the cost-effectiveness of the program. Methods: A total of 400 individuals from nine PR centers across Canada, Europe, and Australia will be recruited to participate in a randomized controlled trial. Individuals with COPD who have a self-reported decline in balance, a fall in the last 2 years, or recent near fall will be randomly assigned to an intervention or control group. The intervention group will undergo tailored balance training in addition to PR and will receive a personalized home-based balance program. The control group will receive usual PR and a home program that does not include balance training. All participants will receive monthly phone calls to provide support and collect health care utilization and loss of productivity data. Both groups will receive home visits at 3, 6, and 9 months to ensure proper technique and progression of home exercise programs. The primary outcome will be incidence of falls at 12-month follow-up. Falls will be measured using a standardized definition and recorded using monthly self-report fall diary calendars. Participants will be asked to record falls and time spent performing their home exercise program on the fall diary calendars. Completed calendars will be returned to the research centers in prepaid envelopes each month. Secondary measures collected by a blinded assessor at baseline (pre-PR), post-PR, and 12- month follow-up will include clinical measures of balance, balance confidence, functional lower body strength, and health status. The cost-effectiveness of the intervention group compared with the control group will be evaluated using the incremental cost per number of falls averted and the incremental cost per quality-adjusted life years gained. Results: Recruitment for the study began in January 2017 and is anticipated to be complete by December 2019. Results are expected to be available in 2020. Conclusions: Findings from this study will improve our understanding of the effectiveness and resource uses of tailored balance training for reducing falls in individuals with COPD. If effective, the intervention represents an opportunity to inform international guidelines and health policy for PR in individuals with COPD who are at risk of falling. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
20. Palliative Care Among Lung Cancer Patients With and Without COPD: A Population-Based Cohort Study.
- Author
-
Butler, Stacey J., Louie, Alexander V., Sutradhar, Rinku, Paszat, Lawrence, Brooks, Dina, and Gershon, Andrea S.
- Subjects
- *
PALLIATIVE treatment , *LUNG cancer , *CANCER patients , *CHRONIC obstructive pulmonary disease , *COHORT analysis - Abstract
Lung cancer patients with chronic obstructive pulmonary disease (COPD) may have greater palliative care needs due to poor prognosis and symptom burden. We sought to compare the provision of timely palliative care and symptom burden by COPD status. We performed a retrospective, population-based cohort study of individuals diagnosed with lung cancer in Ontario, Canada (2009–2019) using health administrative databases and cancer registries. The impact of COPD on the probability of receiving palliative care was determined accounting for dying as a competing event, overall and stratified by stage. The provision of palliative care for patients with severe symptoms (Edmonton Symptom Assessment Scale score ≥ 7), location of the first palliative care visit and symptom severity were compared by COPD status. A total of 74,993 patients were included in the study (48% of patients had available symptom data). At the time of lung cancer diagnosis, 50% of patients had COPD. Stage I–III patients with COPD were more likely to receive palliative care (adjusted Hazard Ratio (HR)s: 1.05–1.31) with no difference for stage IV (1.02, 95% CI: 1.00–1.04). Despite having severe symptoms, very few patients with early-stage disease received palliative care (Stage I: COPD-23% vs. no COPD-18%, SMD = 0.12). Most patients (84%) reported severe symptoms and COPD worsened symptom burden, especially among early-stage patients. COPD impacts the receipt of palliative care and symptom burden for patients with early-stage lung cancer. Many patients with severe symptoms did not receive palliative care, suggesting unmet needs among this vulnerable population. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
21. Perspectives of healthcare professionals and patients on the application of mindfulness in individuals with chronic obstructive pulmonary disease.
- Author
-
Harrison, Samantha L., Lee, Annemarie, Goldstein, Roger S., and Brooks, Dina
- Subjects
- *
OBSTRUCTIVE lung disease treatment , *MEDICAL personnel , *MINDFULNESS , *THEMATIC analysis , *TREATMENT effectiveness , *OBSTRUCTIVE lung disease diagnosis , *OBSTRUCTIVE lung diseases , *ADAPTABILITY (Personality) , *INTERVIEWING , *MEDITATION , *HEALTH outcome assessment , *PATIENT satisfaction , *PSYCHOTHERAPY , *RESPIRATION , *QUALITATIVE research , *PSYCHOLOGY ,ANXIETY prevention - Abstract
Objective: To explore the views of healthcare professionals (HCPs) and patients towards mindfulness for individuals with COPD.Methods: A qualitative study design informed by and analyzed using deductive thematic analysis. Twenty HCPs, with at least one year's clinical experience in COPD management and 19 individuals with moderate to severe COPD participated in semi-structured interviews.Results: Analysis revealed seven themes. 1. Mindfulness is difficult to articulate and separate from relaxation. 2. Mindfulness has a role in disease management. 3. Mindfulness therapy should be optional. 4. Preferred techniques include; breathing meditation, music and body scan. 5. Mindfulness should be delivered by knowledgeable, enthusiastic and compassionate trainers. 6. Preferred mode of delivery is shorter sessions delivered alongside pulmonary rehabilitation, with refresher courses 7. Efficacy should be assessed using psychological outcome measures and qualitative methodologies.Conclusions: Mindfulness appears to be an attractive therapy for individuals with COPD. An understanding of the perspectives of HCPs and patients should inform the delivery of such programs.Practical Implication: Individuals with COPD were comfortable using breathing to reduce anxiety. Stigma and negative preconceptions were considered barriers to participation. Short sessions delivered by experienced trainers were preferred. A combination of methodologies should be used to examine effectiveness. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
22. Prevalence of comorbidities and impact on pulmonary rehabilitation outcomes
- Author
-
Lok Sze Katrina Li, Stacey J. Butler, Andrea S. Gershon, Dina Brooks, Roger S. Goldstein, Lauren Ellerton, Butler, Stacey J, Li, Lok Sze Katrina, Ellerton, Lauren, Gershon, Andrea S, Goldstein, Roger S, and Brooks, Dina
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,comorbid conditions ,lcsh:Medicine ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,medicine ,Pulmonary Rehabilitation ,Pulmonary rehabilitation ,030212 general & internal medicine ,chronic obstructive pulmonary disease (COPD) ,COPD ,Univariate analysis ,business.industry ,lcsh:R ,Interstitial lung disease ,Retrospective cohort study ,Original Articles ,respiratory system ,medicine.disease ,Connective tissue disease ,Comorbidity ,respiratory tract diseases ,3. Good health ,030228 respiratory system ,pulmonary rehabilitation (PR) programmes ,business - Abstract
Background The presence of comorbid conditions could impact performance in pulmonary rehabilitation (PR) programmes. We aimed to compare the comorbidity prevalence among those with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) and evaluate the impact on PR response. Methods We performed a retrospective cohort study, recording comorbidities for all patients with COPD or ILD referred to PR. Participants were classified as responders to PR if they met the minimal important difference for exercise capacity and health-related quality of life (HRQoL). The prevalence of comorbidities and impact on PR outcomes were compared by lung disease and by sex using a univariate analysis and multivariate logistic regression. Results The mean number of comorbidities was similar among those with COPD (3.3±2.1, n=242) and ILD (3.2±1.9, n=66) (p>0.05). Females had a higher number of comorbidities than males in both COPD (p=0.001) and ILD (p=0.017) populations. Circulatory (64%) and endocrine/metabolic (45%) conditions were most common in COPD. In ILD, digestive (55%) and circulatory (53%) comorbidities were most prevalent. In people with ILD, those over 65 years, with musculoskeletal/connective tissue disease or circulatory disease were less likely to obtain meaningful improvements in exercise capacity. There was no impact of comorbidities on exercise capacity in COPD or on HRQoL in ILD. Conclusions The majority of patients with COPD or ILD enrolled in PR programmes have multiple comorbidities that may affect improvements in exercise capacity. PR programmes may be less effective for older adults with ILD and comorbid circulatory or musculoskeletal disease., Comorbidities are common in people with chronic lung disease and can affect their ability to exercise. People with COPD have a similar comorbidity profile to people with interstitial lung disease (ILD). People with ILD and musculoskeletal disease or circulatory conditions are less likely to improve their exercise capacity after pulmonary rehabilitation. http://bit.ly/2p8WSIn
- Published
- 2019
23. Motivation and physical activity in COPD: an exploratory study
- Author
-
Bruno P. Carreira, Chris Burtin, Ana Beatriz Oliveira, José Ribeiro, Filipa Januário, Rúben Caceiro, Cândida Silva, Fernando Silva, Joana Cruz, Sara Pimenta, Nuno Morais, Lília Andrade, Dina Brooks, Alda Marques, Sofia Flora, Fátima Rodrigues, Pimenta, Sara, Flora, Sofia, Silva, Candida G., Oliveira, Ana, Morais, Nuno, Ribeiro, Jose, Silva, Fernando, Caceiro, Ruben, Carreira, Bruno P., Januario, Filipa, Andrade, Lilia, Rodrigues, Fatima, Brooks, Dina, BURTIN, Chris, Marques, Alda, and Cruz, Joana
- Subjects
Gerontology ,COPD ,business.industry ,Physical activity ,medicine ,Exploratory research ,Physiotherapy care ,medicine.disease ,business - Abstract
A key factor for the adoption of an active lifestyle is self-determined motivation; however, it is often overlooked in COPD. Understanding the motives underlying patients’ decision to be (or not) physically active will provide insight into future interventions. This study assessed the motives for patients with COPD to engage in physical activity (PA) and their association with PA behaviour. A cross-sectional study was conducted in stable patients with COPD. Motivation was assessed with the Exercise Motivation Inventory-2 (EMI-2; score 0[Not at all true for me]–5[Very true for me]; 5 dimensions) and PA with accelerometry [ActiGraph-GT3X+, 7 days; moderate to vigorous PA (MVPA), steps/day]. Spearman’s correlations (ρ) were used to assess their relationship. 60 participants were enrolled (67.2±7.7 years; 76.7% men; FEV1 49.5±19.7pp). Patients’ motives to be physically active were mostly Health, Fitness and Psychological. Correlations with PA were weak and non-significant (p>0.05) (Table 1). Patients with COPD value Health, Fitness and Psychological motives to be physically active, although these are not related to their PA behaviour. Findings highlight the complex nature of PA and the need to further explore factors influencing PA and motivation in this population. info:eu-repo/semantics/publishedVersion
- Published
- 2021
24. Relationship between fatigue, physical activity and health-related factors in COPD
- Author
-
Joana Cruz, Carla Valente, Chris Burtin, Sónia Carina Silva, Cândida Silva, Fernando Silva, Alda Marques, Vitória Martins, Telma Matos, Dina Brooks, Diana Dias, Eunice Miguel, Ana Rita Vieira, Rúben Caceiro, José Ribeiro, Ana Beatriz Oliveira, Nuno Morais, Sofia Flora, Vieira , Ana, Dias, Diana, Miguel, Eunice, Matos, Telma, Flora, Sofia, Silva, Candida G., Morais, Nuno, Oliveira, Ana, Caceiro, Ruben, Silva, Fernando, Ribeiro, Jose, Silva , Sonia, Martins, Vitoria, Valente, Carla, BURTIN, Chris, Brooks, Dina, Marques, Alda, and Cruz, Joana
- Subjects
Gerontology ,COPD ,business.industry ,Physical activity ,medicine ,Health related ,Physiotherapy care ,medicine.disease ,business - Abstract
Fatigue is highly prevalent in COPD and may be associated with reduced physical activity (PA) and poor outcomes. This study explored the relationship between fatigue, objectively measured PA and health-related factors in people with COPD. Fatigue was assessed with the Checklist of Individual Strength (CIS20) and CIS20-Subjective Fatigue (CIS20-SF) and PA with Actigraph GT3X monitors (moderate-to-vigorous PA, MVPA; total PA; steps/day). Dyspnoea (modified Medical Research Council, mMRC), exercise tolerance (6-min walk distance, 6MWD), lung function (spirometry) and GOLD AD were collected. Spearman (ρ) and Pearson (r) correlations and multiple regressions were performed. Variables entered the model if correlation≥0.2. 54 patients participated (68±7 years; 82% men) and 69% reported fatigue (CIS20-SF≥27). Fatigue was significantly correlated with MVPA, steps/day, mMRC, 6MWD, GOLD AD and FEV pp (Table 1). In regression models for CIS20 (p=.001; r =.61) and CIS20-SF (p=.003; r =.56), dyspnoea was the only significant variable. Table 1. Descriptives and correlations between fatigue, PA and health-related factors. Descriptives CIS20 CIS20-SF 1 2 2 d THANK YOU FOR ACCEPTING COOKIES You can now hide this message or find out more about cookies. Hide More info
- Published
- 2021
25. Design and delivery of home-based telehealth pulmonary rehabilitation programs in COPD: A systematic review and meta-analysis.
- Author
-
Michaelchuk, Wade, Oliveira, Ana, Marzolini, Susan, Nonoyama, Mika, Maybank, Aline, Goldstein, Roger, and Brooks, Dina
- Abstract
Rationale: Home-based telehealth pulmonary rehabilitation (HTPR) for chronic obstructive pulmonary disease (COPD) is increasingly common partly due to the COVID-19 pandemic. However, optimal HTPR programming has not been described. This review provides a comprehensive overview of the design, delivery, and effects of HTPR for people with COPD.Methods: Relevant databases were searched to July 2021 for studies on adults with COPD utilizing information or communication technology to monitor or deliver HTPR. A meta-analysis was performed on a subset of randomized controlled trials.Results: Of 3124 records retrieved, 38 studies evaluating 1993 individuals with stable COPD (age 54-75 and FEV1 31-92% predicted) were included. Program components included exercise and education (n = 17) or exercise alone (n = 15) with in-clinic baseline assessments commonly conducted (n = 26). Few trials (n = 7) featured synchronous virtual exercise supervision. Aerobic exercise commonly involved walking (n = 14) and cycling (n = 11) and most programs included resistance training (n = 25). Exercise progressions and emergency action plans were inconsistently reported. Meta-analysis demonstrated HTPR was comparable to outpatient PR and had a greater effect than usual care for the modified Medical Research Council dyspnea scale (mean difference [95 %CI]: -0.49 [-0.77, -0.22], p < 0.01) and COPD Assessment Test score (-4.90 [-7.13, -2.67], p < 0.01). Neither HTPR nor outpatient PR impacted sedentary time or step count. Only 6% of studies reported race and no studies reported participant ethnicity.Conclusion: This review revealed the heterogeneity of HTPR program designs in COPD. HTPR programs had similar effects to outpatient PR programs and greater effects than usual care for people with COPD. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.