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Kyphosis may reduce the force of coughing by affecting the factors related to cough peak flow (CPF). This study sought to compare cough strength and respiratory function between non-kyphotic and kyphotic elderly individuals and clarify the relationship between these factors. The non-kyphotic group comprised 17 elderly individuals with a kyphosis index of less than 15.1, while the kyphotic group comprised 21 elderly individuals with a kyphosis index of 15.1 or higher. Cough strength, respiratory function, respiratory muscle strength, and maximum phonation time were measured, and comparison between two groups and correlation analysis between variables were performed. CPF, vital capacity, maximum expiratory pressure (PEmax), maximum inspiratory pressure (PImax), and chest expansion at the xiphoid process were significantly lower in the kyphotic group than in the non-kyphotic group. There were significant negative correlations between kyphosis index and CPF (r = −0.37, p < 0.05), PEmax (r = −0.45, p < 0.01), PImax (r = −0.44, p < 0.01) and chest expansion at the xiphoid process (r = −0.38, p < 0.05). Our results demonstrated that cough strength was significantly lower in the kyphotic compared to non-kyphotic individuals. Furthermore, cough strength decreased with increased severity of kyphosis. [ABSTRACT FROM AUTHOR]

AbstractAimsMethodsResultsConclusionsRehabilitation is commonly used in older patients with mild cognitive impairment (MCI). This study aimed to determine whether MCI affects the effectiveness of rehabilitation in older patients.This was a retrospective cohort study of patients who received rehabilitation in convalescent rehabilitation wards (CRW) in Japan between January 2021 and December 2022.141 patients who met inclusion criteria were included in this study. The patients were divided into MCI and non-MCI groups based on the Mini Mental State Examination score. At admission, MCI patients were significantly older, and had longer hospital stays, malnutrition, lower grip strength, and lower motor independence measures (FIMS) scores. After propensity score matching to adjust for differences in baseline characteristics, motor FIMS scores at discharge remained lower in the MCI group.The presence of MCI is associated with ADL at discharge in older adults admitted to a CRW for rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: We aimed to examine the relationship between physical performance and readmission among older patients with heart failure (HF) over the past year., Methods: This retrospective cohort study included 325 patients with HF who were aged ≥65 years and were hospitalized for acute exacerbation between November 2017 and December 2021. We investigated age, sex, body mass index, length of hospital stay, initiation of rehabilitation, New York Heart Association (NYHA) class, Charlson comorbidity index (CCI) score, medications, cardiac/renal function, nutrition, maximal quadriceps isometric strength, grip strength, and Short Physical Performance Battery (SPPB) score. Data were analyzed using the χ 2 test, Mann-Whitney U test, and logistic regression analysis., Results: Altogether, 108 patients met the inclusion criteria and were divided into the non-readmission (n = 76) and readmission (n = 32) groups. The readmission group exhibited longer hospital stay, more severe NYHA class, higher CCI score, higher brain natriuretic peptide (BNP) levels, lower muscle strength, and lower SPPB score compared to the non-readmission group. In the logistic regression model, BNP level and SPPB score were independent factors associated with readmission., Conclusion: BNP level and SPPB score were associated with readmission in patients with HF within the past year., Competing Interests: The authors report no conflicts of interest., (©2023 Japanese Society of Physical Therapy.)

Background : Assistive use of short-acting β2 agonists (SABAs) reportedly improves exercise tolerance, activities of daily living, and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). However, the effect of SABA on physical activity (PA) is unclear. Objective : This study aimed to determine whether assistive use of SABA increases PA and whether additional pulmonary rehabilitation (PR) can aid further improvement. Methods : Twelve outpatients with COPD and dyspnea during daily activities despite regular use of long-acting bronchodilators were enrolled. This study comprised a 2-week pre-intervention investigation, a 12-week investigation of SABA effects, and an 8-week investigation of the additional effects of PR. Assistive use of SABA was allowed up to 4 times per day after the pre-intervention period. PA was measured for 14 consecutive days using an accelerometer sensor. Dyspnea, exercise tolerance, and HRQOL were evaluated at entry, at 4 and 12 weeks after initiating SABA use, and after completing PR. Results : Assistive use of SABA improved breathlessness during daily activities and increased PA ( p < .001). PA and HRQOL were also improved following PR ( p < .001 and p = .013, respectively). Conclusions : Combined therapy of SABA and PR can increase PA and HRQOL in COPD patients.

Background: While the efficacy of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been well established, emerging evidence also suggests its benefit in idiopathic pulmonary fibrosis (IPF). However, the differences and similarities between how PR affects diseases with different physiologies remain unknown. Objective: This study aimed to compare the efficacy of PR in COPD and IPF patients by performing multifactorial evaluation with various exercise capacity measurements, and dyspnea and health-related quality of life (QoL) assessment. Methods: Twenty-two IPF patients (%vital capacity: 72%) and 27 COPD patients (%forced expiratory volume 1 : 43%) were recruited. Subjects who completed a 10-week outpatient PR program were analyzed. We assessed five exercise capacity indicators (6-minute walking distance, incremental shuttle walking distance, endurance time, peak work rate, and peak values for oxygen uptake [peak VO 2 ]), dyspnea (Baseline Dyspnea Index: BDI), and health-related QoL (St. George's Respiratory Questionnaire: SGRQ) at baseline and immediately following completion of the PR program. Results: After 10 weeks of PR, all exercise capacity measurements, except VO 2 , as well as BDI and SGRQ score improved significantly (p<0.05) in both disease groups. The magnitude of the observed changes in each outcome, assessed by the effect size, was comparable between IPF and COPD patients. This was also true for endurance time, the measurement most responsive to PR, with a large effect size. Conclusions: PR can result in comparable improvements in exercise capacity, including endurance time, and dyspnea and HRQoL in both IPF and COPD patients after 10 weeks of exercise training. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 283-289) ., (Copyright: © 2017.)

Background: Although pulmonary rehabilitation (PR) has been reported to improve exercise capacity in patients with idiopathic pulmonary fibrosis, it is unknown which exercise measurement is the most responsive for evaluation of PR efficacy. The purpose of this study was to compare the responsiveness of 5 exercise measurements by evaluating the efficacy of PR in subjects with idiopathic pulmonary fibrosis., Methods: We conducted a prospective observational study in which 53 subjects with idiopathic pulmonary fibrosis were enrolled. The PR group underwent a 10-week out-patient PR program. The control group was observed without any additional intervention, including PR. Five exercise measurements (endurance time [ET], peak work rate, peak oxygen consumption [V̇O2 ], 6-min walk distance, and incremental shuttle walk distance) were evaluated at baseline and after 10 weeks. The effect size was used for the assessment of responsiveness., Results: In each group, 24 subjects completed the 5 measurements at baseline and after 10 weeks. The changes in ET (PR: 181.6%; control: -8.2%), peak V̇O2 (PR: 7.6%; control: -5.4%), peak work rate (PR: 15.1%; control: -5.1%), 6-min walk distance (PR: 6.0%; control: -3.8%), and incremental shuttle walk distance (PR: 9.1%; control: -5.1%) were significantly different between the groups after 10 weeks (P < .05). In the PR group, ET showed the most striking improvement among the 5 measurements (P < .05), and its effect size was as large as 2.96, whereas those of the others were all < 0.5., Conclusions: ET is the most responsive exercise measurement for evaluating PR efficacy in patients with idiopathic pulmonary fibrosis., (Copyright © 2014 by Daedalus Enterprises.)