BODE index and pulmonary rehabilitation in chronic respiratory failure

Biscione, Gianluca; Mugnaini, L; Pasqua, Franco; Crigna, Girolmina; Ferri, Luigi; Cardaci, Vincenzo; Gargano, Romana; Granone, Pierluigi; Cesario, Alfredo

doi:10.1183/09031936.06.0147705

Cited by 8 publications

(3 citation statements)

References 4 publications

(4 reference statements)

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“…In the present study we haven't used the BODE index which does capture the beneficial effects induced by pulmonary rehabilitation. 26 We have previously shown 27 that BODE in severe and elderly chronic obstructive pulmonary disease subjects with chronic respiratory failure significantly improved after an inpatient pulmonary rehabilitation programme. But in our opinion this multidimensional index is not properly designed to detect severe disability after an acute episode in poorly independent patients.…”

Section: Discussionmentioning

confidence: 96%

Use of functional independence measure in rehabilitation of inpatients with respiratory failure

Pasqua¹,

Biscione²,

Crigna³

et al. 2009

Respiratory Medicine

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Most outcomes do not deeply express the degree of disability in patients with respiratory failure (RF) following inpatient pulmonary rehabilitation (IPR). The aim of our study was to evaluate the efficacy of an IPR in patients with confirmed COPD and RF using functional independence measure (FIM) that determines the degree of disability experienced by patients and the progress they make during rehabilitation. This scale includes several items: self care, mobility, locomotion, communication and social recognition. Twenty-two patients (age 70+/-2 years, PO(2) 58.18+/-7.63mmHg, PCO(2) 46.82+/-9.11mmHg) were prospectively observed and studied. IPR included respiratory and peripheral muscle training, mucus evacuation techniques, and energy conservation techniques. FIM, Medical Research Council dyspnoea scale (MRC), St. George's Respiratory Questionnaire (SGRQ), and 6-min walking distance (6-MWD) were assessed on admission (pre) and discharge (post) from IPR. After IPR there was a statistically significant improvement (p<0.01) in all the FIM items (total score in self care, mobility, locomotion, social recognition) except for communication. Changes of MRC (pre 4.32+/-0.84; post 3.00+/-1.15, p<0.001), SGRQ (%) (pre 69.86+/-4.62; post 46.50+/-11.94, p<0.001), and 6-MWD (pre 164.54+/-98.63; post 214.32+/-97.64, p<0.001) paralleled those improvements. An inverse correlation between MRC and FIM (r=-0.5042, p=0.016) was observed. Our preliminary study has shown that the benefits of IPR in COPD with RF do not only translate in dyspnoea, exercise capacity and quality of life but also within neuromotor disabilities as assessed by FIM. Our results warrant future studies in pulmonary rehabilitation using FIM as an outcome measure.

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Section: Discussionmentioning

confidence: 96%

Use of functional independence measure in rehabilitation of inpatients with respiratory failure

Pasqua¹,

Biscione²,

Crigna³

et al. 2009

Respiratory Medicine

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“…However, limited research has been conducted regarding HRQL of COPD patients in the context of Thai society [2,3,17]. For this reason, this study aimed to examine its related factors, based on the clinical outcome indicators of the quality of life status modifications [18], as BMI, dyspnea, readmission, exercise capacity, and depression. Therefore, the purpose of this study was to explore components of HRQL and its related factors in Thai patients with stable COPD.…”

Section: Introductionmentioning

confidence: 99%

Health-Related Quality of Life and Related Factors in Thais with Stable COPD

Noonil

Petsirasan

Aekwarangkoon

2018

Walailak J Sci & Tech

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This cross-sectional descriptive study aimed to describe the health-related quality of life (HRQL) and related factors of the southern Thai patients with stable COPD. The sample consisted of 126 patients with stable COPD attending the out-patient pulmonary clinic of Thasala hospital. The patients were assessed for HRQL by the Saint George's Respiratory Questionnaire (SGRQ), age, BMI, depression, dyspnea by the Modified Medical Research Council (mMRC), exercise capacity by the 6 min walk distance (6MWD), and admission. The results found that 84 % of patients were male, with a mean age of 69.6 years, FEV1 70 (9.6) % predicted, BMI 21.9 (4.4) and 6MWD 259.8 (97.9). The HRQL indicated mild impairment: symptoms 47.1 (22.4), activity 49.7 (30.3), impact 41.9 (21.2) and total scores of 45.1 (21.7). The regression analysis showed that HRQL was significantly associated with exercise capacity, depression, and MRC dyspnea respectively (R2 = 0.492, p < 0.01). Therefore, stable COPD patients should be assessed and motivated to pulmonary rehabilitation for promoting clinical outcomes and also improving their HRQL.

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“…For this reason we have planned a more comprehensive clinical experimentation to add more power to our preliminary results within properly controlled prospected trials (we are perfectly aware that at least in the PrePR setting, recruitment can be quite difficult). Moreover we are pursuing a translational approach investigating, on the clinical side, the value of the BODE index [4] as a validated indicator of the effects of PR and, on the opposite side of the translational research loop, the possible validation of some molecular biomarkers (mostly related to oxidative stress) to verify any potential match and value in the monitoring of the effects of PR in COPD and NSCLC surgical patients.…”

mentioning

confidence: 99%

Pulmonary rehabilitation in patients undergoing resection for non-small cell lung cancer. A preoperative and postoperative added value

Ferri

Cesario

Margaritora

et al. 2008

European Journal of Cardio-Thoracic Surgery

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We read with interest the report from Bobbio et al. on preoperative pulmonary rehabilitation (Pre-PR) in COPD/ non-small cell lung cancer (NSCLC) patients who are candidates for surgery [1]. We have recently published our own experience based on early stage NSCLC patients where surgery could not be considered due to impaired pulmonary function [2]. The eight patients who accepted to enter the study could then be operated (necessary functional criteria for surgery were re-met). Interestingly a degree of functional amelioration was noticed: increases were observed in the FVC, both in terms of volume and percentage of that predicted (+0.44 l and +12.9%, respectively) and less significantly in FEV1. Apart from this, an amelioration of the exercise endurance (6 min walking test) was reported.We would like to invite the authors of [1] to discuss the possible reasons for this difference (no substantial change in function, as expressed by volumes, in their experience vs a significant change in ours) whereas, apart from the differences in the protocol (the length and the 'inpatient' condition may have helped situations like suspension of smoking habit/compliance to therapy along with a comprehensive psychological support to foster motivation), we could attest to the fact that only patients with a very impaired function were enrolled in our observation and this fact may have given a certain enhancement to the relative improvement of volumes (potential interpretation bias).Our group has a long lasting interest in pulmonary rehabilitation in NSCLC surgical patients. In fact we have recently published our experience in postoperative pulmonary rehabilitation (Post-PR) whereas most functional parameters among treated (rehabilitated) patients were improved and, on the contrary, global function in the control group (non-rehabilitated patients) was homogeneously decreased [3]. Despite the substantial difference at baseline in functional terms of the two groups (rehabilitated worse, non-rehabilitated better), the comparison of treated vs untreated patients 1 month after the operation did not show significant difference thus demonstrating a clinically significant amelioration in the treated ones.Both the PrePR and the PostPR approaches have proved to benefit NSCLC patients who are candidates for or who have undergone surgery. For this reason we have planned a more comprehensive clinical experimentation to add more power to our preliminary results within properly controlled prospected trials (we are perfectly aware that at least in the PrePR setting, recruitment can be quite difficult). Moreover we are pursuing a translational approach investigating, on the clinical side, the value of the BODE index [4] as a validated indicator of the effects of PR and, on the opposite side of the translational research loop, the possible validation of some molecular biomarkers (mostly related to oxidative stress) to verify any potential match and value in the monitoring of the effects of PR in COPD and NSCLC surgical patients.As well we would like t...

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BODE index and pulmonary rehabilitation in chronic respiratory failure

Cited by 8 publications

References 4 publications

Use of functional independence measure in rehabilitation of inpatients with respiratory failure

Use of functional independence measure in rehabilitation of inpatients with respiratory failure

Health-Related Quality of Life and Related Factors in Thais with Stable COPD

Pulmonary rehabilitation in patients undergoing resection for non-small cell lung cancer. A preoperative and postoperative added value

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