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- Faager, Gun
(författare)
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Adjuvant strategies in exercise performance for patients with chronic obstructive pulmonary disease - COPD
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic obstructive pulmonary disease (COPD) is a multicomponent disease which affects both the lungs and organs outside the lungs. Patients with moderate to severe COPD are restricted by dyspnoea, especially during physical activities. This results in the patient avoiding such activities only to further impair physical capacity and to exert a negative effect on quality of life. It is, therefore, of great importance to establish strategies that can optimise the effect of physical exercise and enhance physical activity among these patients. This thesis is based on four studies that investigate the effects of a physiotherapy programme on patients requiring long-term oxygen therapy (LTOT) as a result of COPD and chronic hypoxia. In addition, it explores the effects of creatine supplementation in combination with physical training and the effects of the oral intake of glucose on arterial oxygen tension, exercise endurance and oxygen consumption in patients with moderate to severe COPD. It also looks at the influence of spontaneous pursed lips breathing (PLB) on oxygen saturation and walking endurance. To evaluate the effects of a physiotherapy programme (n=20) and the combination of creatine supplementation with physical training (n=23) two different walking tests were used. Activity of daily living and health related quality of life were also assessed. To determine whether or not pursed lips breathing influences exercise endurance (n=32), an endurance shuttle walking test and transcutaneous oxygen saturation were conducted. The effect of oral glucose intake (n=13) was evaluated in respect of arterial blood gas analysis, oxygen uptake, carbon dioxide production, ventilation and endurance time on a bicycle ergometer. Patients with chronic obstructive pulmonary disease receiving long-term oxygen treatment may improve their walking distance, experience less dyspnoea and improve their ability to perform daily activities after a physiotherapy programme. Creatine supplementation in combination with physical training showed no significant improvement in physical performance, muscle strength, pulmonary function and health related quality of life in patients with severe to moderate COPD when compared with physical training alone. However, the creatine group showed significant increased walking time after the eight-week training programme. When spontaneous pursed lips breathing was used the patients walked longer, with a significant difference in oxygen saturation in favour of spontaneous PLB. The technique can be useful to increase walking endurance and reduce oxygen desaturation during walking in patients with moderate to severe COPD. Oral intake of glucose may increase the arterial oxygen tension in COPD patients with slight to moderate hypoxia at rest, paralleled with increased blood lactate. When an oral glucose solution is taken before a bicycle exercise test there appears to be no increase in endurance or improved oxygen saturation. On the contrary, glucose intake may be associated with reduced ventilatory reserves and higher ratings of dyspnoea.
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- Faager, Gun, et al.
(författare)
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Creatine supplementation and physical training in patients with COPD : a double blind, placebo-controlled study.
- 2006
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Ingår i: International journal of chronic obstructive pulmonary disease. - : Informa UK Limited. - 1176-9106. ; 1:4, s. 445-53
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVES: Patients with chronic obstructive pulmonary disease (COPD) have low exercise capacity and low content of high energetic phosphates in their skeletal muscles. The aim of the present study was to investigate whether creatine supplementation together with exercise training may increase physical performance compared with exercise training in patients with COPD. DESIGN: In a randomized, double-blind, placebo-controlled study, 23 patients with COPD (forced expiratory volume in one second [FEV1] < 70% of predicted) were randomized to oral creatine (n = 13) or placebo (n = 10) supplementation during an 8-week rehabilitation programme including exercise training. Physical performance was assessed by Endurance Shuttle Walking Test (ESWT), dyspnea and leg fatigue with Borg CR- 10, quality of life with St George's Respiratory Questionnaire (SGRQ). In addition, lung function test, artery blood gases, grip strength test, muscle strength and fatigue in knee extensors were measured. RESULTS: COPD patients receiving creatine supplementation increased their average walking time by 61% (ESWT) (p < 0.05) after the training period compared with 48% (p = 0.07) in the placebo group. Rated dyspnea directly after the ESWT decreased significantly from 7 to 5 (p < 0.05) in the creatine group. However, the difference between the groups was not statistically significant neither in walking time nor in rated dyspnea. Creatine supplementation did not increase the health related quality of life, lung function, artery blood gases, grip strength and knee extensor strength/fatigue. CONCLUSIONS: Oral creatine supplementation in combination with exercise training showed no significant improvement in physical performance, measured as ESWT, in patients with COPD compared with exercise training alone.
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- Pettersson, Henrik, et al.
(författare)
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Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery : a randomized controlled trial
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 47:8, s. 748-752
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Breathing exercises after cardiac surgery are often performed in a sitting position. It is unknown whether oxygenation would be better in the standing position. The aim of this study was to evaluate oxygenation and subjecfive breathing ability during sitting vs standing performance of deep breathing exercises on the second day after cardiac surgery.Methods: Patients undergoing coronary artery bypass grafting (n=189) were randomized to sitting (controls) or standing. Both groups performed 3 x 10 deep breaths with a positive expiratory pressure device. Peripheral oxygen saturation was measured before, directly after, and 15 min after the intervention. Subjective breathing ability, blood pressure, heart rate, and pain were assessed.Results: Oxygenation improved significantly in the standing group compared with controls directly after the breathing exercises (p <0.001) and after 15 min rest (p=0.027). The standing group reported better deep breathing ability compared with controls (p=0.004). A slightly increased heart rate was found in the standing group (p= 0.047).Conclusion: After cardiac surgery, breathing exercises with positive expiratory pressure, performed in a standing position, significantly improved oxygenation and subjective breathing ability compared with sitting performance. Performance of breathing exercises in the standing position is feasible and could be a valuable treatment for patients with postoperative hypoxaemia.
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