The Effectiveness of Ballon Blowing Exercise on Increasing Expiratory Forced Volume Value in 1 Second (FEV1) and Oxygen Saturation among COPD patients
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Balloon-blowing exercise is a breathing technique that is used to reduce breathlessness and improve lung expansion. The purpose of this study is to explain the difference in effectiveness balloon blowing exercise to the increase in value FEV1 and oxygen saturation in COPD patients. This study used a quasi-experimental design with a pre-test post-test study; the study population was patients with COPD in Taman Husada Bontang hospitals. Consecutive sampling techniques do sampling following the inclusion criteria, with a total of 20 patients. Intervention balloon blowing exercise performed 3 times per week within 4 weeks. The results showed that there are positive effects on FEV1 (p-value= 0.001) and oxygen saturation (p-value 0.02). Balloon-blowing exercise could increase in value FEV1 and oxygen saturation in patients with COPDKeywords:
Oxygen Saturation
Saturation (graph theory)
Background: to date, a reliable functional predictor of acute bronchodilator response in terms of forced expiratory volume in 1 second (FEV1) in patients with COPD does not exist. We hypothesized that ventilation inhomogeneity may have a role in the distribution of inhaled drugs. Aim: to explore which physiological parameter is predictive of FEv1 response in patients with COPD Methods: an interventional, randomized, double blind, double dummy study was conducted in the Pulmonary Rehabilitation Unit of S. Maugeri, Milan, Italy. The acute effects of tiotropium 18 µg (TIO) and indacaterol 150 µg (IND) on closing volume (CV) and ventilation inhomogeneity were investigated in patients with moderate to very severe COPD. Patients underwent body plethysmography, arterial blood gas analysis, dyspnea assessment, and simultaneous recording of single-breath N2 test and transpulmonary pressure-volume curve (PLV), before and 1 h after drug administration. Results: 50 stable COPD patients, 25 per arm, (mean±SD age 70±7 yr, 82% men) were enrolled. Pre-bronchodilator and post-bronchodilator parameters did not differ between groups (ΔFEV1 90±110 vs. 60±110 mL, for IND and TIO;P=0.296), therefore results were pooled. ΔFEV1 significantly correlated with baseline vital capacity (Pearson coefficient, VC, 0.283; P=0.047), total lung capacity (TLC, 0.295; P=0.038) and closing volume to VC ratio (CV/VC, 0.483;P=0.023). In a multivariate regression model, only CV/VC significantly predicted the FEV1 response to bronchodilators (Beta -0.010; 95%CI: -0.017,-0.002; P=0.013). Conclusion: the amount of closed airways during drug inhalation affects the response to bronchodilators in terms of airflow obstruction.
Transpulmonary pressure
Plethysmograph
Indacaterol
Vital capacity
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This study was conducted to evaluate whether forced expiratory volume in 1 second (FEV1) for the diagnosis of bronchial reactivity by means of the free-running exercise test and bronchodilator inhalation, could be appropriately replaced by simple measurements of peak expiratory flow rate (PEFR) in children.We studied 108 referred symptomatic children (due to chronic cough or wheezing) suspected to have asthma aged 5-14y. Forced breathing spirometry and the "Mini-Wright peak flow meter" tests were recorded before and fifteen minutes after the challenge with free- running exercise or bronchodilator (Salbutamol) inhalation, regarding the baseline FEV1 value (FEV1> 80% considered as normal).There was a high correlation between PEFR and FEV1 (in absolute value and percent predicted) measured before and after bronchodilator inhalation test (r = 0.48, P = 0.05) in comparison to the values referred to free- running exercise test (r = 0.26, P = 0.01)."forced breathing spirometry" and "Mini-Wright peak flow" cannot be used interchangeably for diagnosing asthma, and PEFR measurement should remain a procedure for monitoring and following up the patients.
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Background and objective: Chronic obstructive pulmonary disease (COPD) is a global health problem leading to poor quality of life and increased healthcare expenditure. Pulmonary dysfunction and dyspnea in COPD patients cause exercise limitation, which leads to chronic avoidance of physical activities. Exercise is highly recommended as an additional therapeutic modality in COPD patients. Therefore, this study aims to investigate the effect of modified arm swing exercise (MASE) training on pulmonary function in patients with COPD. Methods: Ten COPD patients (aged 66.88 + 2.67 yrs) without cardiovascular complication in Khon Kaen province were recruited. They performed 30-min MASE per day, 6 days per week for 12 weeks. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal expiratory pressure (PEmax), maximal inspiratory pressure (PImax), modified Medical Research Council (mMRC) dyspnea scale and COPD Assessment Test TM (CAT) scores were assessed before and after exercise. Results: After the MASE, PEmax was significantly increased from 99.38 + 10.58 to 111.00 + 12.09 cmH 2 O (p < 0.05). Moreover, CAT scores were significantly decreased from 11.38 + 1.77 to 8.75 + 1.55 (p < 0.05) after MASE training. However, FEV1, FVC, FEV 1 /FVC ratio, PEF, PImax and mMRC dyspnea scale did not change after MASE training. Conclusions: These data demonstrated that MASE training increases expiratory muscle strength and improves impact of COPD on patients’ health status in patients with COPD. Thus, MASE may be suggested to be an alternative mode of exercise for the COPD patients.
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Objective To look for alternate index of forced vital capacity. Methods Pulmonary ventilatory function was conducted in 304 patients with stable chronic obstructive lung disease from January 2011 to October 2012. 197 cases of male and female 107 cases; average age( 64. 7 ± 13. 5) years old. Measure including FVC,1 second forced expiratory volume( FEV1),2 second forced expiratory volume( FEV2),3 second forced expiratory volume( FEV3),4 second forced expiratory volume( FEV4),5 second forced expiratory volume( FEV5) and forced expiratory volume in six seconds( FEV6),7 second forced expiratory volume( FEV7),8 second forced expiratory volume( FEV8),9 second forced expiratory volume( FEV9). Analysis of Correlation between expiratory volume( FEV) and FVC. Results All patients were complete lung ventilation function index detection,including Ⅱ grade 157 cases of patients with lung function( 51. 6%),Ⅲ grade 124 patients( 40. 8%), Ⅳ grade 23 patients( 7. 6%),no pulmonary function in patients with stageⅠ. All patients exhale average time of( 6. 7 ±3. 1) s,observed volume- time curves found in 193 cases( 63. 5%) patients with expiratory phase to reach a plateau,111 cases( 36. 5%) patients with no respiratory plateau,these people were aged 65 years; grade Ⅱ 15 cases in lung function( 4. 9%),grade Ⅲ 75 cases( 24. 7%),grade Ⅳ 21 cases( 6. 9%). Patient expiratory time measurement results,77. 6%( 236/304) of patients with expiratory time were 6 s,36. 8 %( 112/ 304) 7 s. Correlation analysis showed,FEV6was positively correlated with FVC( r = 0. 357,P = 0. 047). Conclusion FVC is difficult to reach a plateau in aged COPD patients with poor lung function. For patients whose expiratory phase can not reach the plateau and fail to complete FVC effectively, FEV6can be used as a surrogate marker for FVC.
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COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters.The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1) percent predicted (%p) in COPD patients and controls.Eighty-one smokers/ex-smokers (41 controls and 40 COPD) performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium.Most pulmonary function parameters showed a linear increase in response to decreased FEV1%p. The subjects were divided into groups of FEV1%p <65 and >65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC), forced vital capacity (FVC), FEV1/FVC and expiratory resistance (Rex), which showed a segmented response relationship to FEV1%p. IC and FVC, with break points (BP) of 57 and 58 FEV1%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV1%p <65 and >65, response of FEV1%p did not correlate to response of volume parameters.Response of several advanced lung function parameters differs depending on patients' baseline FEV1%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV1%p <65. Volume and resistance responses do not follow the flow response measured with FEV1 and may thus be used as a complement to FEV1 reversibility to identify flow, volume and resistance responders.
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Introduction: Long term oxygen therapy (LTOT) improves survival in patients with COPD with resting hypoxemia. Despite this, a progressive loss of lung function and physical ability is expected in COPD. The AIRVO device delivers nasal high flow (NHF) warmed and humidified oxygen-enriched air, 20-30 L/minute via the Optiflow interface to COPD patients in need of LTOT. Aim: To investigate the treatment effect of NHF on lung function, (Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) in liters and percent, 6 minute walking test (6MWT) and modified MRC (mMRC) dyspnoea scores in COPD patients with resting hypoxemia over 12 months. Method: In this prospective, randomized controlled, one-year study, 200 COPD patients, all FEV1 GOLD class 4, treated with LTOT, were randomized to AIRVO-NHF (n=100) or usual care (n=100) between March 2013 and June 2015. Results: The two treatment groups are comparable in average days in study, age, gender, smoking status, pack years, BMI, FEV1 and FVC, L and %, 6MWT and number of exacerbations and admissions one year prior to study start, although controls had better mMRC at baseline. At 12 months, AIRVO-NHF patients had significantly more improved FEV1% (p<0.05) and 6MWT (p<0.05). After 3 months AIRVO-NHF patients had significantly more improved mMRC scores (p<0.05) with statistical significance of p<0.0001 after 12 months whether as change or absolute values. Conclusion: These results show a significant treatment effect in favor of AIRVO-NHF preventing decrease in FEV1, increasing 6MWT and mMRC score (in particular) in COPD patients in need of LTOT.
Vital capacity
Oxygen therapy
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Objective To explore notable changes in vital capacity and expiratory volume in patients with COPD and asthma using bronchodilator.Methods Compare the amount and rate of vital capacity(FVC) and expiratory volume(FEV1) before and after inhaling salbutamol in patients with COPD and asthma.Results After bronchial dilation test,FVC in patients with COPD increased 191 ml and improved by 12.93%,but FEV1 only increased 63 ml and improved by 10.01%;FVC in patients with asthma increased 363 ml and improved by 15.34% on average,but FEV1 increased 289 ml and improved by 23.57%.Conclusion The increase of forced vital capacity is more significant than that of expiratory volume in patients with COPD,but asthma is opposite.The measure of forced vital capacity should become a valuable objective index to identify the patient's condition for COPD.
Vital capacity
Bronchodilator Agents
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Background: High-flow oxygen therapy (HFOT) provides oxygen-enriched, humidified, and heated air at high flow rates via nasal cannula. It could be an alternative to low-flow oxygen therapy (LFOT) which is commonly used by patients with chronic obstructive pulmonary disease (COPD) during exercise training. Research Question: We evaluated the hypothesis that HFOT improves exercise endurance in COPD patients compared to LFOT. Methods: Patients with stable COPD, FEV 1 40–80% predicted, resting pulse oximetry (SpO 2 ) ≥92%, performed two constant-load cycling exercise tests to exhaustion at 75% of maximal work rate on two different days, using LFOT (3 L/min) and HFOT (60 L/min, FiO 2 0.45) in randomized order according to a crossover design. Primary outcome was exercise endurance time, further outcomes were SpO 2 , breath rate and dyspnea. Results: In 79 randomized patients, mean ± SD age 58 ± 9 y, FEV 1 63 ± 9% predicted, GOLD grades 2-3, resting PaO 2 9.4 ± 1.0 kPa, intention-to-treat analysis revealed an endurance time of 688 ± 463 s with LFOT and 773 ± 471 s with HFOT, mean difference 85 s (95% CI: 7 to 164, P = 0.034), relative increase of 13% (95% CI: 1 to 28). At isotime, patients had lower respiratory rate and higher SpO 2 with HFOT. At end-exercise, SpO 2 was higher by 2% (95% CI: 2 to 2), and Borg CR10 dyspnea scores were lower by 0.8 points (95% CI: 0.3 to 1.2) compared to LFOT. Interpretation: In mildly hypoxemic patients with COPD, HFOT improved endurance time in association with higher arterial oxygen saturation, reduced respiratory rate and less dyspnea compared to LFOT. Therefore, HFOT is promising for enhancing exercise performance in COPD. Clinical Trial Registration: www.ClinicalTrials.gov , identifier: NCT03955770.
Crossover study
Nasal cannula
Oxygen pulse
Oxygen therapy
Pulse Oximetry
Endurance Training
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