A Qualitative Study to Inform a More Acceptable Pulmonary Rehabilitation Program after Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Current international guidelines for prevention of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) recommend enrolment and participation in a pulmonary rehabilitation (PR) program within 4 weeks of hospital discharge. However, there is poor uptake of these programs as well as low adherence and completion rates. The objectives of this study were to explore the views of patients and healthcare professionals (HCPs) on PR after AECOPD and how participation could be enhanced.

Using a virtual game system to innovate pulmonary rehabilitation: safety, adherence and enjoyment in severe chronic obstructive pulmonary disease.

Objective: The present pilot study tested the use of a virtual game system (VGS) for exercise training in patients with moderate to very severe chronic obstructive pulmonary disease undergoing pulmonary rehabilitation (PR). Safety, feasibility, enjoyment and adherence were assessed.

Methods: VGS (Wii [2006], Nintendo, USA) games were prescreened and categorized into lower- and upper-body workouts.

Unilateral hemidiaphragm weakness is associated with positional hypoxemia in REM sleep.

Background: Patients with unilateral diaphragmatic paralysis (UDP) have been reported to have varied respiratory symptoms and often reduced lung function. We sought to describe the polysomnographic respiratory characteristics in patients with UDP without obstructive sleep apnea.

Methods: We prospectively collected 5 cases with clinical investigation regarding symptoms, lung function, and nocturnal polysomnography.

Patient knowledge in chronic obstructive pulmonary disease: back to basics.

Patient education is integral to the care of patients with chronic obstructive pulmonary disease (COPD), and a cornerstone of self-management in chronic illness. We aimed to assess information needs and knowledge of patients with COPD. The Lung Information Needs Questionnaire (LINQ) and The Mount Sinai Hospital Questionnaire (MSHQ) were used.

Development of a patient needs assessment model for pulmonary rehabilitation.

Patients with chronic obstructive pulmonary disease are often referred to pulmonary rehabilitation programs to manage their symptoms and the consequences of the disease on their lives. Finding ways to target programs to a specific patient's needs could help improve individual response to the program. The purpose of this study was to develop a conceptual model for the assessment of patients' rehabilitation needs by using a grounded theory approach.

Fatigue in COPD: prevalence and effect on outcomes in pulmonary rehabilitation.

Patients with chronic obstructive pulmonary disease (COPD) complain of dyspnea and fatigue. We sought to estimate the prevalence of high fatigue in this population and to determine whether individuals with high fatigue had a different response to pulmonary rehabilitation. This observational study was embedded within a randomized trial.

Leak profile inspection during nasal continuous positive airway pressure.

Background: Patients treated with nasal continuous positive airway pressure (nasal CPAP) for obstructive sleep apnea (OSA) often have adverse effects from and poor adherence to CPAP.

Objective: To describe abnormal CPAP leak profiles and assess inter-observer reliability in identifying leak profiles and the correlation of leak profiles with leak rate and clinical outcomes.

Methods: In a sleep-disorders clinic we prospectively studied 35 consecutive patients newly diagnosed with moderate or severe OSA, and who had undergone polysomnographic diagnosis and nasal CPAP titration.

Classifying medication use in clinical research.

Background: Medication use data are usually collected in clinical research. Yet no standardized method for categorizing these exists, either for sample description or for the study of medication use as a variable.

Objective: The present investigation was designed to develop a simple, empirically based classification scheme for medication use categorization.

Success in pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.

Background: Pulmonary rehabilitation (PR) is beneficial for some, but not all, patients with chronic lung disease.

Objectives: To determine the success rate of a comprehensive PR program for patients with chronic obstructive pulmonary disease (COPD) and to characterize the differences between responders and nonresponders.

Methods: A chart review was performed on patients with a clinical diagnosis of COPD who were referred for PR.

Impaired sleep in chronic fatigue syndrome: how is it best measured?

The goal was to examine comparative efficacy of polysomnography, actigraphy, and self-report in evaluating the sleep/wake experience of individuals with chronic fatigue syndrome (CFS). Sleep parameters were evaluated by the three measurement modalities for the same night in 49 participants with CFS. Psychological and daytime functioning were measured by self-report.

Sleep apnea and psychological functioning in chronic fatigue syndrome.

Objectives were to explore: (1) whether sleep apnea/hypopnea syndrome (SAHS) should be considered a chronic fatigue syndrome (CFS) comorbidity, rather than a diagnostic exclusion criterion; and (2) to compare sleep/wake/ psychopathology in individuals with CFS, controls and another illness. Participants (CFS, SAHS, controls) completed questionnaires and were evaluated for SAHS; 68 percent were subsequently diagnosed with SAHS. CFS participants with and without SAHS did not differ.

Evidence of interrelated side effects with reduced compliance in patients treated with nasal continuous positive airway pressure.

Objectives: Patients treated for obstructive sleep apnea syndrome (OSAS) with nasal continuous positive airway pressure (nCPAP) often have side effects and poor compliance. Our objectives were to explore their side effects when treated with nCPAP and to validate the association of a side effect syndrome with the outcomes of sleep quality, daytime sleepiness and nCPAP compliance.

Methods: Prospective exploratory and subsequent validation study using questionnaires was performed in a tertiary-care sleep-disorders clinic.

Prevalence of persistent sleep apnea in patients treated with continuous positive airway pressure.

Study Objective: There are limited data on the prevalence of persistent obstructive sleep apnea (OSA) in patients who are clinically asymptomatic with continuous positive airway pressure (CPAP). Our objectives were to estimate the prevalence of persistent OSA and to explore the parameters that may be capable of discriminating these patients.

Design: Prospective survey.

Pulmonary rehabilitation improves functional capacity in patients 80 years of age or older.

Objectives: There is limited evidence that pulmonary rehabilitation improves exercise capacity in older patients with chronic respiratory disease. The objective of the present study was to determine whether patients 80 years of age or older gain similar benefits from pulmonary rehabilitation as do younger patients.

Design: Outcomes were compared in 230 consecutive inpatients with moderate to severe lung disease who participated in a comprehensive pulmonary rehabilitation program during a one-year period.