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October 2011

PR Literature Reviews

Exercise testing

Title: Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test.
Authors: Andersson M, Moberg L, Svantesson U, Sundbom A, Johansson H, Emtner M.
Source: Prim Care Respir J. 2011 Sep 21. pii: pcrj-2011-03-0044-R1. doi: 10.4104/pcrj.2011.00082. [Epub ahead of print].

Summary: Adresson et al. aimed to examine test-retest reliability of the 30-metre walk test (30mWT) in patients with chronic obstructive pulmonary disease (COPD) and to compare the 30mWT with the 6-minute walk test (6MWT). The 30mWT is a reliable submaximal test that is easy to perform and can be used to measure physical function (walking ability) in patients with COPD.

Title: Six Minute Walk Distance Predictors, Including Computed Tomography Measures, in the COPDGene(R) Cohort.
Authors: Rambod M, Porszasz J, Make BJ, Crapo JD, Casaburi R; and the COPDGene Investigators.
Source: Chest. 2011 Sep 29. [Epub ahead of print].

Summary: Rambod et al. determined whether other phenotypic characteristics, including computerized tomography (CT) measures, are independent predictors of 6 minute walk distance (6MWD) in the COPDGene(®) cohort. In this large cohort of smokers, in a given spirometric stage phenotypic characteristics were only modestly predictive of 6MWD. CT measures of emphysema and gas trapping were not predictive of 6MWD after adjustment for other phenotypic characteristics.

Title: Physiological Effects of Roflumilast at Rest and during Exercise in COPD.
Authors: O'Donnell DE, Bredenbröker D, Brose M, Webb KA.
Source: Eur Respir J. 2011 Sep 29. [Epub ahead of print].

Summary: The purpose of this study was to investigate the effects of 500 μg roflumilast taken once daily for 12-weeks on airway physiology during rest and exercise in patients with moderate to severe COPD. Newly described non-bronchodilator effects of roflumilast included small but consistent improvements in air trapping and arterial oxygen saturation during exercise

Title: Reference values for the incremental shuttle walking test.
Authors: Probst VS, Hernandes NA, Teixeira DC, Felcar JM, Mesquita RB, Gonçalves CG, Hayashi D, Singh S, Pitta F.
Source: Respir Med. 2011 Aug 22. [Epub ahead of print].

Summary: This study aimed to determine which anthropometric and demographic variables influence the walking distance achieved in the ISWT in healthy subjects with a broad age range and to establish a reference equation for predicting ISWT for that population. The variability of the ISWT is explained largely by gender, age and BMI. The reference values for the ISWT can be adequately predicted using the equation proposed in this study.

Co-morbidities

Title: COPD and the metabolic syndrome: an intriguing association.
Authors: Clini E, Crisafulli E, Radaeli A, Malerba M.
Source: Intern Emerg Med. 2011 Oct 2. [Epub ahead of print].

Summary: Clini et al. review the interplay between coexisting COPD and the metabolic syndrome, based on the most updated knowledge.

Title: Extrapulmonary comorbidities in chronic obstructive pulmonary disease: state of the art.
Authors: Patel AR, Hurst JR.
Source: Expert Rev Respir Med. 2011 Oct;5(5):647-62.

Summary: Patel et al. provide a state-of-the-art summary of key comorbidities observed in COPD patients in terms of their prevalence, impact, pathophysiology and prognosis.

Title: The Impact of Ischemic Heart Disease on Symptoms, Health Status and Exacerbations in COPD.
Authors: Patel AR, Donaldson GC, Mackay AJ, Wedzicha JA, Hurst JR.
Source: Chest. 2011 Sep 22. [Epub ahead of print].

Summary: The impact of ischemic heart disease on COPD in terms of health status, exercise capacity and symptoms is not well understood. Comorbid ischemic heart disease is associated with worse health status, lower exercise capacity and more dyspnea in stable COPD patients and longer exacerbations, but not an increased exacerbation frequency.

Symptoms of dyspnea

Title: A multidimensional computer adaptive test approach to dyspnea assessment.
Authors: Norweg A, Ni P, Garshick E, O'Connor G, Wilke K, Jette AM.
Source: Arch Phys Med Rehabil. 2011 Oct;92(10):1561-9.

Summary: Norweg et al. aimed to develop and test a prototype dyspnea computer adaptive test (CAT). The Dyspnea Management Questionnaire-CAT reliably and validly captured 4 distinct dyspnea domains.

Physical (in)activity

Title: Evidence of an early physical activity reduction in chronic obstructive pulmonary disease patients.
Authors: Gouzi F, Préfaut C, Abdellaoui A, Vuillemin A, Molinari N, Ninot G, Caris G, Hayot M.
Source: Arch Phys Med Rehabil. 2011 Oct;92(10):1611-1617.e2. Epub 2011 Sep 8.

Summary: Gouzi et al. aimed to compare the lifetime pattern of physical activity (PA) in chronic obstructive pulmonary disease (COPD) patients and sedentary healthy subjects (SHS) using a PA questionnaire with a lifetime period of recall (Quantification de l'Activité Physique [QUANTAP] system), and to compare the pattern of PA reduction in COPD patients with the onset of breathlessness and other relevant clinical events in this disease (diagnosis, first rehabilitation, onset of smoking). The observation of an early PA reduction, preceding the onset of breathlessness, suggests the implication of prior pathologic mechanisms in the PA reduction of COPD patients.

Long-term oxygen therapy

Title: Review of Burn Injuries Secondary to Home Oxygen.
Authors: Murabit A, Tredget EE.
Source: J Burn Care Res. 2011 Sep 28. [Epub ahead of print].

Summary: The use of long-term home oxygen therapy (HOT) has become increasingly common for the treatment of chronic pulmonary disease. Although illegal to smoke while on HOT, there is an increasing incidence of burn injuries in those patients who smoke while on HOT. The importance of recognition of the prevalence of this injury, the obstacles faced when treating these patients, and understanding the proposed algorithmic approach to be taken with patients on HOT, including prescription, reassessment, and prevention of burn injury are outlined in this review.

Title: Long-Term Oxygen Therapy in COPD: Factors Affecting and Ways of Improving Patient Compliance.
Authors: Katsenos S, Constantopoulos SH.
Source: Pulm Med. 2011;2011:325362. Epub 2011 Sep 15.

Summary: The present review article highlights factors influencing the compliance of patients using LTOT and emphasizes novel strategies and interventions that may prove to be of significant benefit given the remarkably little current research appraising this issue.

Social environment

Title: Shifting life rhythms: Couples' stories about living together when one spouse has advanced chronic obstructive pulmonary disease.
Authors: Ek K, Ternestedt BM, Andershed B, Sahlberg-Blom E.
Source: J Palliat Care. 2011 Autumn;27(3):189-97.

Summary: This study examines couples' experiences of living together when one partner has advanced chronic obstructive pulmonary disease (COPD). The healthy spouse had major responsibility for the health of their sick spouse. Awareness of the couple's own conceptions and knowledge of health and illness is central to person-focused care, as is awareness of what values are important to them when restructuring their everyday life.

Title: Paid employment in subjects with and without chronic obstructive pulmonary disease in five Latin American cities: the PLATINO study.
Authors: Montes de Oca M, Halbert RJ, Talamo C, Perez-Padilla R, Lopez MV, Muiño A, Jardim JR, Valdivia G, Pertuzé J, Moreno D, Menezes AM; PLATINO team.
Source: Int J Tuberc Lung Dis. 2011 Sep;15(9):1259-64.

Summary: The objective was to examine the frequency of paid employment and factors influencing it in a Latin-American population-based study. Although the proportion of persons with paid work is lower in COPD, having COPD appears not to have a significant impact on obtaining paid employment in the overall population of developing countries.

Pulmonary rehabilitation and exercise training

Title: Two-year home-based nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients: A randomized controlled trial.
Authors: Duiverman ML, Wempe JB, Bladder G, Vonk JM, Zijlstra JG, Kerstjens HA, Wijkstra PJ.
Source: Respir Res. 2011 Aug 23;12:112.

Summary: The aim was to compare the outcome of 2-year home-based nocturnal NIPPV in addition to rehabilitation (NIPPV + PR) with rehabilitation alone (PR) in COPD patients with chronic hypercapnic respiratory failure. The addition of NIPPV to pulmonary rehabilitation for 2 years in severe COPD patients with chronic hypercapnic respiratory failure improves HRQoL, mood, dyspnea, gas exchange, exercise tolerance and lung function decline. The benefits increase further with time.

Title: Exercise assessment and training in pulmonary rehabilitation for patients with COPD.
Authors: Singh S, Harrison S, Houchen L, Wagg K.
Source: Eur J Phys Rehabil Med. 2011 Sep;47(3):483-97.

Summary: The purpose of this article is to describe the assessment process, exercise intervention and its anticipated benefits, in the context of a rehabilitation programme for individuals with COPD.

Title: Exercise assessment and training in pulmonary rehabilitation for patients with COPD.
Authors: Wouters EF, Augustin IM.
Source: Eur J Phys Rehabil Med. 2011 Sep;47(3):475-82.

Summary: Wouter et al. state that in an optimal health care organizational structure, pulmonary rehabilitation needs to be considered as an essential part of an individualized, integrated care process, organized from the vantage point of the patient and the patients' health continuum.

Title: Scope, background and definition of pulmonary rehabilitation.
Authors: Nici L, Zuwallack R.
Source: Eur J Phys Rehabil Med. 2011 Sep;47(3):465-74.

Summary: Nici et al. state that pulmonary rehabilitation is an important therapeutic option in situations like this, providing a mode of integrating care, complementing otherwise standard medical therapy, and producing significant gains across multiple outcome areas of importance to the patient.

Title: Pulmonary Rehabilitation for Moderate COPD (GOLD 2) -Does it Have an Effect?
Authors: Gottlieb V, Lyngsø AM, Nybo B, Frølich A, Backer V.
Source: COPD. 2011 Oct;8(5):380-6.

Summary: The aim of the present survey was to evaluate the effect of rehabilitation in patients with moderate COPD and to determine their willingness to participate in rehabilitation. Although an effect was found of pulmonary rehabilitation in subjects with moderate COPD, it disappeared over 18 months. Only a minority of patients with moderate COPD referred for rehabilitation accepted and completed the treatment offer.

Palliative care

Title: A Randomized Trial to Improve Communication about End-of-Life Care among Patients with COPD.
Authors: Au DH, Udris EM, Engelberg RA, Diehr PH, Bryson CL, Reinke LF, Curtis JR.
Source: Chest. 2011 Sep 22. [Epub ahead of print].

Summary: Au et al. assessed whether an intervention using patient-specific feedback about preferences for discussing end-of-life care would improve the occurrence and quality of communication between patients with COPD and their clinicians. A 1-page patient-specific feedback form about preferences for end-of-life care and communication improved the occurrence and quality of communication from patients' perspectives.

Health education

Title: Patient knowledge in chronic obstructive pulmonary disease: back to basics.
Authors: Scott AS, Baltzan MA, Dajczman E, Wolkove N.
Source: COPD. 2011 Oct;8(5):375-9.

Summary: Scott et al. aimed to assess information needs and knowledge of patients with COPD. Patients with COPD have received information and demonstrate some knowledge about their disease. However, there remains a need for more education on diet and self-management.

Title: A Randomized Controlled Trial of a Literacy-Sensitive Self-Management Intervention for Chronic Obstructive Pulmonary Disease Patients.
Authors: Kiser K, Jonas D, Warner Z, Scanlon K, Bryant Shilliday B, Dewalt DA.
Source: J Gen Intern Med. 2011 Sep 21. [Epub ahead of print].

Summary: Kiser et al. aimed to explore the impact of a literacy-sensitive self-management intervention on inhaler technique scores in COPD patients and to determine if effects differ by literacy. A literacy-sensitive self-management intervention can lead to improvements in inhaler technique, with benefits for patients with both low and higher health literacy.

Title: Patients' experiences of health transitions in pulmonary rehabilitation.
Authors: Halding AG, Heggdal K.
Source: Nurs Inq. 2011 Aug 18. doi: 10.1111/j.1440-1800.2011.00573.x. [Epub ahead of print].

Summary: This study explores the experience of patients with COPD in terms of their transitions in health during and after PR. The study highlights the personal resources that patients with COPD have access to in order to promote their own health. The study also highlights their vulnerability during illness and rehabilitation. The findings critique time-limited PR and support the current trends towards patient-centred rehabilitation efforts that incorporate user involvement and self-management education.

Muscle function

Title: Quadriceps strength assessed by magnetic stimulation of femoral nerve in patients with chronic obstructive pulmonary disease.
Authors: Ju CR, Chen RC.
Source: Chin Med J (Engl). 2011 Aug;124(15):2309-15.

Summary: Ju et al. aimed to investigate the prevalence and severity of skeletal muscle dysfunction in COPD patients by measurement of quadriceps strength with volitional and non-volitional techniques, and to probe into some methodological issues. Quadriceps strength is commonly and substantially impaired in patients with COPD, in terms of MVC as well as TwQ. The magnetic stimulation of the femoral nerve presents a higher reproducibility and is a better technique for measurement of quadriceps strength for the general population, especially for those who are too unwell to perform a full MVC; while it may not be applied to subjects who are over-weighted.