Search

BackgroundObjectiveMethodsResultsConclusionThe coexistence of pain and chronic obstructive pulmonary disease (COPD) is acknowledged, yet the pain prevalence and associated factors of the common pain area in the COPD population are unknown.This study aims to examine the prevalence of pain in individuals with and without COPD and to explore the connections between common pain areas and related factors.Data was gathered through spirometry tests and surveys, including demographics, pain characteristics, Shoulder Pain and DisabilityIndex (SPADI), Neck Disability Index (NDI), COPD assessment test, and dyspnea score.Comparing pain characteristics between 85 individuals with COPD and 85 age- and gender-matched non-COPD subjects, results showed significantly higher pain prevalence (75.3% versus 42.4%, p < .001), pain severity (3.9 ± 3.1 versus 2.1 ± 2.8, p < .001), pain locations (2 [IQR 0.5, 4.0] versus 0 [IQR 0.0, 2.0], p < .001), NDI (1.9 ± 5.3 versus 0.3 ± 1.7, p < .001), and SPADI (10.1 ± 17.4 versus 4.4 ± 10.6, p < .001) in individuals with COPD. The shoulder is the most common area of pain, followed by the thoracic region and the lower extremities. Notably, individuals with COPD with shoulder pain were more likely to have multiple pain locations (OR = 1.53 [95% CI 1.17, 2.01], p = .002), a high SPADI score (OR = 1.10 [95% CI 1.03, 1.16], p = .003), and a reduced % predicted of forced expiratory volume in the first second (%predicted FEV1) (OR = 0.96[95% CI 0.92, 0.99], p = .018).Individuals with COPD exhibit higher pain prevalence than those without, especially in the shoulder area. Multiple pain locations, SPADI score, and % predicted FEV1may predict shoulder pain in individuals with COPD. The findings suggest further research on shoulder pain causes to develop better treatments for individuals with COPD. [ABSTRACT FROM AUTHOR]

Upper quadrant geometrical changes in individuals with chronic obstructive pulmonary disease (COPD) appear to have negative influences on geometrical arrangements of the thorax and scapula. The purpose of this systematic review was to assess the impairment of scapular control in individuals with COPD as compared with healthy controls. We systematically searched seven electronic databases from inception to June 2021 and updated the searches again in December 2021. Eligible studies included the participants with COPD and compared scapular control outcomes (scapular/shoulder kinematic or related muscle activity) with a control group. Two researchers independently searched for, screened, extracted data from, and evaluated the quality of all articles. Seven studies met the inclusion criteria and only five studies with 190 subjects were included in the meta-analyses. Subgroup analyses showed that the control group exhibited more scapular anterior tilt (SMD: 0.46; 95% CI: 0.01 to 0.90) and shoulder flexion (SMD: −1.02; 95% CI: −1.79 to −0.26) as compared with the COPD group. Conversely, the COPD group exhibited more scapular elevation (SMD: −1.03; 95% CI: −1.69 to −0.37), internal rotation (SMD: −1.65; 95% CI: −3.19 to −0.10), and protraction (SMD: −0.75; 95% CI: −1.18 to −0.32) compared with the control group. All other outcomes revealed non-significant findings. This review demonstrated scapular control impairments, such as scapular elevation, internal rotation, protraction, and anterior tilt in a static position in patients with COPD. To validate these findings, high-quality randomized control trials with large sample sizes and reliable outcome measures should be conducted. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary rehabilitation (PR) is essential for long-term management of chronic obstructive pulmonary disease (COPD). However, evidence regarding the effectiveness of various PR delivered via telemedicine (tele-pulmonary rehabilitation [tele-PR]) is lacking. This study aims to assess the comparative effects of different tele-PR types on clinical outcomes in patients with COPD. Methods: The following databases were searched: PubMed, EMBASE, CENTRAL, CINAHL, and EBSCO Open Dissertations from inception to May 2023. We included randomized controlled trials, quasi-experimental, and cohort studies investigating the effects of tele-PR on exercise capacity. The Cochrane Effective Practice and Organization of Care Group risk of bias was used to assess the quality of included studies. Data were analyzed using STATA 17.0 with a random-effects model. Tele-PR comparisons were ranked using surface under the cumulative ranking (SUCRA). Results: Seven studies ( n = 815) encompassing five tele-PR types were included in the network meta-analysis. Two studies were justified as having a high risk of bias. There were no significant differences among different types of tele-PR and face-to-face PR, in terms of improving the 6-minute walk test. However, the hierarchy estimation suggested that tele-coaching by virtual agents more often than three sessions per week is more likely to be better than other tele-PRs (SUCRA 95.4%). Discussion: While uncertainty persists regarding the optimal tele-PR delivery model, our study suggests that tele-PR was not different from face-to-face PR. However, limited studies and evidence of low-quality underscore the need for well-designed clinical trials to yield more robust comparative evidence.