Literature Reviews

July 2011

Rehabilitation and exercise training

Title: Feasibility and preliminary efficacy of progressive resistance exercise training in lung cancer survivors.
Peddle-McIntyre CJ, Bell G, Fenton D, McCargar L, Courneya KS.
Source: Lung Cancer. 2011 Jun 27. [Epub ahead of print].

Summary: Peddle-McIntyre et al. report the feasibility and preliminary efficacy of a progressive resistance exercise training intervention in post-treatment lung cancer survivors. It is a feasible intervention with potential health benefits for a small proportion of lung cancer survivors in the post-treatment setting.

Title: Preoperative pulmonary rehabilitation before lung cancer resection: Results from two randomized studies.
Benzo R, Wigle D, Novotny P, Wetzstein M, Nichols F, Shen RK, Cassivi S, Deschamps C.
Source: Lung Cancer. 2011 Jun 8. [Epub ahead of print].

Summary: Benzo et al. tested two preoperative PR interventions in patients undergoing lung cancer resection and with moderate-severe COPD in a randomized single blinded design. Their results suggest the potential for short term preoperative pulmonary rehabilitation interventions in patients with moderate-severe COPD undergoing curative lung resection. 4 weeks of conventional preoperative PR seems non feasible.

Title: Aerobic exercise attenuates pulmonary injury induced by exposure to cigarette smoke.
Toledo AC, Magalhaes RM, Hizume DC, Vieira RP, Biselli PJ, T Moriya H, Mauad T, Lopes FD, Martins MA.
Source: Eur Respir J. 2011 Jun 23. [Epub ahead of print].

Summary: The present study evaluated the effects of regular exercise training in an experimental mouse model of chronic cigarette smoke (CS) exposure in male C57BL/6 mice. Toledo et al. conclude that regular aerobic physical training of moderate intensity attenuates the development of pulmonary disease induced by cigarette smoke exposure.

Title: Rehabilitation and acute exacerbations.
Burtin C, Decramer M, Gosselink R, Janssens W, Troosters T.
Eur Respir J. 2011 Jun 30. [Epub ahead of print].

Summary: This review aims at describing the systemic consequences of acute exacerbations of COPD and compiles evidence for the feasibility and effectiveness of different rehabilitation strategies to counteract these consequences during and/or immediately after the acute phase of the exacerbation.

Title: Improvement of Cognitive Function After a Three-Month Pulmonary Rehabilitation Program for COPD Patients.
Pereira ED, Viana CS, Taunay TC, Sales PU, Lima JW, Holanda MA.
Lung. 2011 Jun 9. [Epub ahead of print].

Summary: The objective of the study was to evaluate the effect of multidisciplinary pulmonary rehabilitation program on cognitive function in COPD patients, adjusting for potential confounders (gender, age, tobacco consumption, and educational level). The improvement in cognitive performance by the COPD patients was evidenced even after adjusting for the sociodemographic factors that could potentially interfere on cognitive function. Male gender and age less than 65 years old were associated to higher scores in verbal learning and memory at baseline and after the rehabilitation program. Pereira et al. conclude that the clinical approach to COPD-induced cognitive dysfunction should include participation in pulmonary rehabilitation programs.

Title: A randomized study of the effects of supplemental exercise sessions after a 7-week COPD rehabilitation program.
Linneberg A, Rasmussen M, Buch TF, Wester A, Malm L, Fannikke G, Vest S.
Clin Respir J. 2011 Jun 8. doi: 10.1111/j.1752-699X.2011.00256.x. [Epub ahead of print].

Summary: Linneberg et al. aimed to investigate the effects of supplemental exercise sessions following an initial 7-week COPD rehabilitation program with regard to exercise capacity and disease-specific. In conclusion, a program of 6 supplemental exercise sessions following the initial 7-week COPD rehabilitation program did not have any effect on exercise performance and quality of life during one year follow-up.

Symptoms of anxiety and depression

Title: Prevalence of anxiety and depression among chronic bronchitis patients and the associated factors.
Authors: de Miguel Díez J, Barrera VH, Maestu LP, Garrido PC, García TG, García RJ.
Source: Respirology. 2011 Jun 27. doi: 10.1111/j.1440-1843.2011.02015.x. [Epub ahead of print].

Summary: The aim of this study was to assess the prevalence of anxiety and depression among patients with chronic bronchitis (CB) and to identify associated factors. De Miguel Diez et al. conclude that anxiety or depression is around twice as frequent among CB patients as it is among those without CB. Variables associated with anxiety or depression among CB patients included female gender and concomitant comorbidities.

Title: Effects of medical and psychological treatment of depression in patients with COPD - A review.
Fritzsche A, Clamor A, von Leupoldt A.
Respir Med. 2011 Jun 14. [Epub ahead of print].

Summary: This review summarizes the current state of findings from studies examining the effects of antidepressant treatments in patients with COPD.

Chronic care

Title: The health, activity, dyspnea, obstruction, age, and hospitalization: Prognostic score for stable COPD patients.
Esteban C, Quintana JM, Aburto M, Moraza J, Arostegui I, España PP, Aizpiri S, Capelastegui A.
Respir Med. 2011 Jun 22. [Epub ahead of print].

Summary: The aim of this study was to develop and validate a new COPD severity score using variables readily obtained in clinical practice and to compare its predictive capacity with that of other multidimensional indexes. The HADO-AH score provides estimates of all-cause and respiratory mortality that are equal to, or better than, those of other multidimensional instruments. Because it uses only easily accessible measures, it could be useful at all levels of care.

Title: Unrecognized ventricular dysfunction in chronic obstructive pulmonary disease.
Macchia A, Moncalvo JJ, Kleinert M, Comignani PD, Gimeno G, Arakaki D, Laffaye N, Fuselli JJ, Massolin HP, Gambarte J, Romero M, Tognoni G.
Source: Eur Respir J. 2011 Jun 23. [Epub ahead of print].

Sumamry: Macchia et al. aimed to assess the prevalence and the prognostic implications of the coexistence of left ventricular dysfunction in COPD patients and airway obstruction in CHF patients. CHF and COPD frequently coexist. Ventricular dysfunction worsens survival in patients with COPD. Considering the high prevalence and the prognostic implications of ventricular dysfunction, routine assessment with either BNP or echocardiogram should be considered in COPD patients.

Title: Measuring the impact of a live, case-based, multiformat, interactive continuing medical education program on improving clinician knowledge and competency in evidence-based COPD care.
Authors: Drexel C, Jacobson A, Hanania NA, Whitfield B, Katz J, Sullivan T.
Source: Int J Chron Obstruct Pulmon Dis. 2011;6:297-307. Epub 2011 May 23.

Summary: Physicians who participated in a half-day regional CME program on COPD diagnosis, staging, and treatment were significantly more likely than nonparticipants to deliver evidence-based COPD care. With multiformat, interactive, focused educational interventions, physicians can make diagnostic and therapeutic choices in the primary care setting that align more closely with current guidelines and clinical evidence in COPD management.

Title: Nurse-led multidisciplinary programme for patients with COPD in primary health care: a controlled trial.
Zakrisson AB, Engfeldt P, Hägglund D, Odencrants S, Hasselgren M, Arne M, Theander K.
Prim Care Respir J. 2011 Jun 17. pii: pcrj-2010-05-0050-R3. doi: 10.4104/pcrj.2011.00060. [Epub ahead of print].

Summary: This study aimed to investigate the effects of a nurse-led multidisciplinary programme (NMP) of pulmonary rehabilitation in primary health care with regard to functional capacity, quality of life (QoL), and exacerbations among patients with COPD. Zakrisson et al. conclude that the NMP in primary care produced a significant reduction in exacerbation frequency, but functional capacity and QoL were unchanged. More and larger studies are needed to evaluate potential benefits in functional capacity and QoL.

Oxygen desaturation and therapy

Title: The Relationship of the BODE Index to Oxygen Saturation During Daily Activities in Patients with Chronic Obstructive Pulmonary Disease.
Authors: Cutaia M, Brehm R, Cohen M.
Source: Lung. 2011 Jun 24. [Epub ahead of print].

Summary: The frequency of oxygen desaturation during daily activities in chronic obstructive pulmonary disease (COPD) is poorly defined. The BODE index predicts survival in COPD. The purpose of this study was to determine the relationship between BODE scores and oxygen saturation during daily activities. Cutaia et al. conclude that oxygen desaturation is linked to disease severity.

Title: Symptomatic oxygen for non-hypoxaemic chronic obstructive pulmonary disease.
Uronis H, McCrory DC, Samsa G, Currow D, Abernethy A.
Cochrane Database Syst Rev. 2011 Jun 15;6:CD006429.

Summary: This systematic review aimed to determine the efficacy of oxygen versus medical air for relief of subjective dyspnoea in mildly or non-hypoxaemic people with COPD who would not otherwise qualify for home oxygen therapy. Uronis et al. conclude that oxygen can relieve dyspnoea in mildly and non-hypoxaemic people with COPD who would not otherwise qualify for home oxygen therapy. Given the significant heterogeneity among the included studies, clinicians should continue to evaluate patients on an individual basis until supporting data from ongoing, large randomised controlled trials are available.