Effectiveness of Non-Presential Individualized Exercise Training PrOgram(NIETO) in Lower Limb Physical Performance in Advanced COPD

Abstract

Muscle training, a component of pulmonary rehabilitation (PR), improves the physical performance of patients with chronic obstructive pulmonary disease (COPD). Despite the existing evidence, the traditional center-based PR model is applied to a small percentage of patients and presents numerous problems of accessibility, adherence, and costs. This study present a home model of simple muscle training, non-presential, monitored by telephone and individualized, according to the severity of the COPD. In addition, to evaluate the results, simple tests associated with the physical performance of the lower limbs, previously validated in COPD, have been used, such as the four-meter walk, speed test (4MGS) and the five-repetition test sitting and standing (5STS). The objective was to evaluate whether the Individualized Non-Presential Exercise Training PrOgram (NIETO) induces improvements in the 4MGS, 5STS and quadriceps muscle strength (QMS) tests in outpatients with advanced COPD (FEV1 ≤ 50%). After one year, the QMS was significantly higher in the intervention group (IG) than in the control group (CG) (2.44 ± 4.07 vs. 0.05 ± 4.26 kg; p = 0.009). The 4MGS and 5STS tests were significantly shorter in IG than in CG (−0.39 ± 0.86 vs. 0.37 ± 0.96 s; p = 0.001) and (−1.55 ± 2.83 vs. 0.60 ± 2.06 s; p = 0.001), respectively. A home model of simple muscle training monitored by telephone such as NIETO, can improve 4MGS, 5STS, and quadriceps strength tests in outpatients with advanced COPD.

Palpation of the Respiratory System in Osteopathic Manual Medicine: From the Trachea to the Lungs

“…To our knowledge, no previous studies on the OMM approach have described the manual evaluation on respiratory tissues in any detail and have instead focused on structural and/or instrumental examination [ 7 , 9 - 12 ]. For example, the forced expiratory volume in 1 second (FEV1), which is a respiratory value obtained from spirometry, is not necessarily related to the presence of dyspnea, physical performance of patients with chronic obstructive pulmonary disease, or to the functionality of the respiratory muscles [ 13 - 14 ]. The manual treatment of the thoracic outlet for thoracic outlet syndrome has been reported to improve respiratory parameters [ 15 ].…”