Effects of pulmonary rehabilitation in patients with asthma

Conemans, Lennart; Agterhuis, Dinette E.; Franssen, Frits; Spruit, Martijn A.; Wouters, Emiel F.M.; Vanfleteren, Lowie E.G.W.

doi:10.1183/13993003.congress-2018.pa2043

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, severe refractory asthma has been related to the presence of low fat-free mass that is comparable to that of GOLD stage IV COPD [41]. Hence, patients attending PR represent an interesting population because of their complexity in terms of symptoms and comorbidities, while demonstrating a high prevalence of obesity and functional impairment [42]. Lastly, it is not clear why obese subjects (especially those with low ALMI) demonstrate less impaired quality of life in the present study Low Lean Mass and Sarcopenic Obesity in Asthma since it has been shown that obese asthmatics experience poorer asthma-related quality of life, compared to asthmatics of a healthy weight [6,43].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation

Meys¹,

Machado²,

Spruit³

et al. 2023

Obes Facts

View full text Add to dashboard Cite

Introduction: One of the most prominent extrapulmonary manifestations in patients with chronic respiratory disease is changes in body weight and composition. However, the frequency and functional consequences of low appendicular lean mass (ALM) or sarcopenic obesity (SO) in patients with asthma are largely unknown. Therefore, the aim of the current study was to assess the frequency and functional consequences of low appendicular lean mass index (ALMI) and SO in patients with asthma. Methods: A retrospectively analyzed cross-sectional study was conducted in 687 patients with asthma (60% female, 58 ± 13 years, FEV1 76 ± 25% pred) referred for comprehensive pulmonary rehabilitation (PR). Body composition, pulmonary function, exercise capacity, quadriceps muscle function, and quality of life were assessed. Patients were classified as presenting low ALMI according to the 10th percentiles of age-sex-body mass index (BMI)-specific reference values and as having SO according to the diagnostic procedure proposed by the 2022 ESPEN/EASO consensus. In addition, clinical outcomes between patients with normal and low ALMI or with and without SO were compared. Results: The frequency of patients classified as low ALMI was 19%, whereas 45% of the patients were obese. Among the obese patients, 29% had SO. In patients with normal weight, those with low ALMI were younger and had worse pulmonary function, exercise capacity and quadriceps muscle function than those with normal ALMI (all p < 0.05). Overweight patients with low ALMI presented poorer pulmonary function and quadriceps muscle function (both strength and total work capacity). In obese class I patients, those with low ALMI showed lower quadriceps strength and maximal oxygen uptake acquired during cardiopulmonary exercise testing. Both male and female patients with SO showed lower quadriceps muscle function and reduced maximal exercise capacity compared to non-SO asthma patients. Conclusion: Approximately one in five asthma patients presented low ALM when age-sex-BMI-specific ALMI cutoffs were applied. Obesity is common among patients with asthma referred for PR. Among the obese patients, a significant proportion presented SO. Low ALM and SO were associated with worse functional outcomes.

show abstract

Section: Strengths and Limitationsmentioning

confidence: 99%

Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation

Meys¹,

Machado²,

Spruit³

et al. 2023

Obes Facts

View full text Add to dashboard Cite

show abstract

“…Extrapolation of generic principles to other populations might be feasible, but caution is warranted. PR programmes including resistance training have shown to be successful in, for example, patients with asthma and interstitial lung disease, and there is limited evidence for pulmonary hypertension, with a recommendation by the European Society of Cardiology and European Respiratory Society for closely supervision of exercise programmes for deconditioned patients . More studies are on the way .…”

Section: Add‐on Interventions In Respiratory Diseases Other Than Copdmentioning

confidence: 99%

Add‐on interventions during pulmonary rehabilitation

Vanfleteren

Gloeckl

2019

Respirology

View full text Add to dashboard Cite

Both pulmonary rehabilitation (PR) and chronic obstructive pulmonary disease (COPD) are generic terms and it increasingly becomes clear that rehabilitation programmes need to be tailored to the complexity and circumstances of the individual patient. Indeed, PR is described as a comprehensive, individualized intervention based on thorough assessment of identifiable treatable traits. The current review summarizes ongoing developments regarding additional interventions and tools to facilitate PR and improve outcomes in patients with a chronic respiratory disease.

show abstract

“…In contrast to previous studies, which appear to suggest a lower magnitude of effect in other respiratory diseases, the current results found a similar degree of improvement, irrespective of disease. Specifically, whilst functional capacity and HRQoL have been reported to be improved by PR in various respiratory conditions, including asthma (Conemans et al, 2018), bronchiectasis (Metersky and ZuWallack, 2019) and in those with pulmonary fibrosis (Gomes-Neto et al, 2018), there has been little consistency in the PR programmes implemented, limiting comparisons and interpretations.…”

Section: Discussionmentioning

confidence: 99%

Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions

McCreery¹

View full text Add to dashboard Cite

Effective rehabilitation strategies are paramount to improve physiological and psychological health in pulmonary disease. The aim of this thesis was to investigate traditional and alternative pulmonary rehabilitation strategies in those with chronic respiratory disease. Chapter Four found that traditional pulmonary rehabilitation (PR) was physiologically and psychologically effective, regardless of respiratory disease, with socioeconomic status being a key determinant of adherence. Chapter Five investigated the feasibility and acceptability of IMT. Children aged 10.8 ± 0.8 years with Cystic Fibrosis (CF) enjoyed the IMT intervention, perceiving improvements in their physical ability and psychosocial health. The care team highlighted that future interventions needed to be longer and to monitor engagement and adherence. Chapter Six assessed the effectiveness of an alternative rehabilitation strategy, using a four-week inspiratory muscle training (IMT) intervention, on lung function and heart rate variability in children with CF aged 10.8 ± 1.1 years. There were significant and clinically meaningful increases in respiratory muscle strength, a clinically meaningful decrease in sympathetic modulation, and decreases in respiratory symptoms. Subsequently, utilising the formative, physiological and psychological findings derived from Chapters Five and Six, an eight-week IMT intervention with live biofeedback, performed at 80% maximal inspiratory pressure, three times a week was implemented, with an eight-week optional IMT top-up. Overall, Chapter Seven found that eight weeks of IMT elicited significant increases in respiratory muscle strength, aerobic capacity and in CF-specific questionnaire domains in children (11.0 ± 2.2 years) with CF, which were maintained following the eight-week top-up period. Chapter Eight demonstrated significant improvements in inspiratory muscle strength and endurance after eight weeks, with sustained improvements in physiological health after 16-weeks in adults with bronchiectasis (64.5 ± 10.3 years). CF and bronchiectasis participants demonstrated high levels of adherence and reported competency and autonomy. Overall, IMT may be an effective and feasible alternative to pulmonary rehabilitation.

show abstract

Effects of pulmonary rehabilitation in patients with asthma

Cited by 3 publications

References 0 publications

Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation

Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation

Add‐on interventions during pulmonary rehabilitation

Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions

Contact Info

Product

Resources

About