Physical therapy added to standard medical treatment of acute exacerbated COPD patients achieves a higher improvement in perceived health status than the prescription of standard medical treatment alone. Implications for Rehabilitation Physical therapy added to standard medical treatment in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease achieves a higher improvement in the perceived health status than the prescription of standard medical treatment alone. Short duration physical therapy programs added to the standard care appear to be helpful in the management of acute exacerbations of chronic obstructive pulmonary disease patients.
Background: Upper limb disturbances are prevalent in patients with Parkinson disease (PD) and can limit their participation in activities of daily living. Tele-assessment of upper limb motor symptoms using an Internet application may be an alternative for addressing the growing demand for monitoring of disease progression. Objective: To evaluate the level of agreement between face-to-face and tele-assessment of patients with PD. Design: Reliability study. Setting: Parkinson's Disease Association. Participants: Twenty-one patients with PD from a local association participated in the study. Methods: Patients attended a session for clinical face-to-face and real-time online tele-assessment. Main Outcome Measurements: Upper limb measures of function (assessed with the Manual Ability Measure 16), dexterity (evaluated using the coin rotation task), motor speed (assessed by the finger tapping test), tremor (evaluated with the Fahn-Tolosa-Marin Tremor Rating Scale), and range of motion (using the Kinovea software) were recorded by two independent researchers. Results: All the outcome measures evaluated showed a good interrater, intraclass correlation coefficient (ρ > 0.75). In addition, most confidence intervals were narrow and excluded 0.8. The lowest reliability was obtained for elbow flexion of the most affected upper limb (ρ = 0.75; confidence interval 0.49-0.89) and the highest reliability for finger tapping tests (ρ = 1; 1, 1). Conclusions: This study demonstrates high interrater reliability of upper limb tele-assessment in patients with PD compared to a face-to-face assessment.
Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was to assess the feasibility and the efficacy of two exercise programs in Acute Exacerbation of COPD (AECOPD) patients with resting hypoxemia. In this randomized clinical trial, patients hospitalized due to an acute exacerbation of COPD with hypoxemia at rest were included. Patients were randomly assigned into three groups. A Control Group (pharmacological treatment), a Global Exercise Group (GEG), and a Functional Electrostimulation Group (FEG). Patients were treated during the hospitalization period. The main outcomes were lower limb strength (assessed by a dynamometer), balance (assessed by the one leg standing balance test), health related quality of life (assessed by the EQ-5D), adverse events and adherence. At the end of the intervention, there were significant differences in all the variables in favour of the experimental groups (p < 0.05). We concluded that conducting an exercise program is feasible and improves lower limb strength, balance, and health related quality of life in AECOPD patients with resting hypoxemia.
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