Cardiopulmonary Response in Post-COVID-19 Individuals: A Cross-Sectional Study Comparing the Londrina Activities of Daily Living Protocol, 6-Minute Walk Test, and Glittre Activities of Daily Living Test.

This study addresses the imperative need for reliable assessment protocols in guiding rehabilitation interventions for individuals post-COVID-19, considering the enduring physiological effects of the virus. A cohort of 40 post-COVID-19 individuals underwent assessments using the Londrina ADL protocol, Glittre ADL test, and the 6-minute walk test (6MWT). Physiological parameters were recorded during and after each test, including heart rate, respiratory rate, and oxygen saturation. The post hoc comparisons between the pre-test and post-test cardiopulmonary response of the three tests showed significant differences, except diastolic blood pressure (6MWT vs. Londrina ADL protocol), heart rate (6MWT vs. Londrina ADL protocol), respiratory rate (6MWT vs. Londrina ADL protocol), blood oxygen level (SpO2) (6MWT vs. Londrina ADL protocol), dyspnea (Londrina ADL protocol vs. Glittre ADL test), and fatigue (Londrina ADL protocol vs. Glittre ADL test). The Londrina ADL protocol demonstrated cardio-pulmonary responses comparable to the Glittre ADL test, as well as the 6MWT, emphasizing its effectiveness in evaluating walking-related outcomes. The study concludes that the Londrina ADL protocol is a robust and practical tool for the routine clinical testing of daily living activities in post-COVID-19 individuals. While the 6MWT remains valuable for assessing walking-related outcomes, a combined approach employing the Londrina ADL protocol and 6MWT offers a comprehensive strategy for evaluating multifaceted functional capacities in this population.

Randomised controlled trial assessing the effects of 6-week telerehabilitation exercise programme on chronic non-specific neck pain: a study protocol.

Chronic non-specific neck pain is one of the most common musculoskeletal conditions affecting the work and lifestyle of those suffering from it. Physiotherapy interventions, such as strength training and stretching, have positively influenced neck pain. Patient adherence to home-based exercises is a growing concern that could be easily improved through telerehabilitation exercise programmes. This can also be a cost-effective, time-efficient and patient-suitable service. Therefore, this study aims to establish the effectiveness of telerehabilitation exercise intervention by measuring patient adherence, pain score, disability index, cervical range of motion (CROM) and cervical muscle endurance. This randomised controlled trial will include n=60 participants, aged 18-45 years, in a 6-week home-based exercise programme delivered through telerehabilitation or paper-based instructions. Outcome measures from participants will be obtained at baseline and on completion of 6 weeks. These will include the Visual Analogue Scale for Pain, Neck Disability Index questionnaire, CROM by using the CROM instrument and cervical muscle endurance through the Craniocervical Flexion Test. For baseline differences between groups, an independent samples t-test will be used. Repeated measures analysis of variance will be used for within-group and between-group analyses at three different time points (0 weeks, 3 weeks, 6 weeks). Trial registration number:NCT06076174.

A survey on awareness of the disease and pulmonary rehabilitation in bronchial asthma patients in the United Arab Emirates.

BACKGROUND: Asthma, a prevalent and severe chronic respiratory condition, can be significantly managed and controlled through informed awareness about the disease and pulmonary rehabilitation strategies, thereby enhancing patients' health-related quality of life. OBJECTIVE: To determine the knowledge and awareness of Bronchial asthma and pulmonary rehabilitation among asthma-diagnosed patients in the United Arab Emirates. METHODS: Utilizing a cross-sectional study design, 237 asthma patients, aged 18 and above, were recruited from the Royal NMC Hospital, Sharjah. A comprehensive questionnaire was administered, focusing on two critical domains: understanding of the disease and knowledge about pulmonary rehabilitation. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) software, version 26. RESULTS: The majority of participants (31.6%) reported the onset of asthma before reaching two years of age. Bronchodilators emerged as the most used medication, utilized by 31.6% of the respondents. Weather conditions (34.6%) were identified as the most prevalent risk factor. Chi-square tests revealed no significant correlations between gender and knowledge about asthma (p = 0.278) or pulmonary rehabilitation awareness (p = 0.929). A negative correlation was found between age and knowledge about asthma (p<0.001), but not with pulmonary rehabilitation awareness (p = 0.731). Education demonstrated no significant association with either knowledge about asthma (p = 0.974) or awareness of pulmonary rehabilitation (p = 0.676). CONCLUSION: The study implies that most people have a basic understanding of asthma. However, there are still significant gaps in their knowledge. For instance, many aren't sure how asthma is influenced by exercise or which parts of the body are affected. Also, understanding about therapies such as lung rehabilitation, and the contributions physical therapists can make in addressing lung problems, is only average. Interestingly, these knowledge gaps are not related to a person's age or their educational background.

Caregiver Perspectives on Physiotherapy Treatment for Paediatric Burns in the United Arab Emirates.

Background: Physiotherapy is an essential component of paediatric burn treatment. Children are admitted to the paediatric burn unit with their caregivers who play a vital role in supporting the child's post-burn physiotherapy management. Objective: The objective of the study is to determine caregivers' attitudes on physiotherapy treatment for children with burns in the UAE. This study focused on the caregiver's perspective on five important domains: caregiver's knowledge, burden, attitude, adherence to physiotherapy exercise program, and caregiver's satisfaction. Methods: A descriptive cross-sectional study was conducted using self-administered questionnaire. Fifty caregivers were eligible to participate in the study. The analyses of the survey responses were done using SPSS software. Descriptive analysis and correlation statistics were used to present the data. Results: The caregiver participants in the study reported to have reasonably good knowledge about the paediatric burns care (13.62 ± 3.49) and had a positive attitude towards the physiotherapy treatment provided to the children with the burn injuries (9.41 ± 1.56). The adherence to the prescribed exercise regimen of physiotherapy sessions was found to be good (11.88 ± 1.50) but were overburdened with the caregiving tasks (21.42 ± 11.62). The study demonstrated very high levels of satisfaction among the caregivers with the physiotherapy treatment sessions provided to the children (13.4 ± 1.83). Conclusion: Caregiver attitude regarding physiotherapy management was overall positive; caregivers were well aware of the importance of physiotherapy and have reported high levels of satisfaction with the paediatric burn physiotherapy management.

Association of Physical Activity and Quality of Life with Work-Related Musculoskeletal Disorders in the UAE Young Adults.

BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) pose threat to the global economy and work productivity. Though growing evidence shows physical activity and quality of life are major determinants for WRMSDs, the association between physical activity and the quality of life among the young adults of the United Arab Emirates (UAE) remains unclear. METHODS: In a cross-sectional study, a total of 507 young adults who were between the ages 18-35 years were administered an interviewer-based survey on musculoskeletal disorders, physical activity, and quality of life. The association between the potential determinants and the WRMSDs was analyzed using linear and logistic regression models. RESULTS: High prevalence (75%) of WRMSDs was found among the UAE young adults. Participants with low leisure-time physical activity had few WRMSDs. There was no significant association between physical activity or quality-of-life scores with the incidence of WRMSDs although physical activity time was highly associated with the quality of life, especially the social domain. CONCLUSION: Though a high prevalence of WRMSDs among UAE men and women was found, neither physical activity nor the quality-of-life scores determined the incidence of WRMSDs.

The Aftermath of the COVID-19 Crisis in Saudi Arabia: Respiratory Rehabilitation Recommendations by Physical Therapists.

Since late 2019, the number of COVID-19 patients has gradually increased in certain regions as consecutive waves of infections hit countries. Whenever this wave hits the corresponding areas, the entire healthcare system must respond quickly to curb the diseases, morbidities, and mortalities in intensive care settings. The healthcare team involved in COVID-19 patients' care must work tirelessly without having breaks. Our understanding of COVID-19 is limited as new challenges emerge with new COVID-19 variants appearing in different world regions. Though medical therapies are finding solutions to deal with the disease, there are few recommendations for respiratory rehabilitation therapies. A group of respiratory rehabilitation care professionals in Saudi Arabia and international experts have agreed with the World Health bodies such as the World Health Organization (WHO) on the treatment and rehabilitation of patients with COVID-19. Professionals participating in COVID-19 patient treatment, rehabilitation, and recovery formulated respiratory rehabilitation guidelines based on the DELPHI Method, combining scientific research and personal practical experience. As a result, it is envisaged that the number of individuals in the region suffering from respiratory ailments due to post-COVID-19 will decrease. This narrative review and clinical expertise guidelines may give physiotherapists acceptable and standard clinical guideline protocols for treating COVID-19 patients.

Evidence based physiotherapy practice in cardiopulmonary subdiscipline: A survey in United Arab Emirates.

BACKGROUND: Evidence based practice (EBP) is widely used by cardiopulmonary physical therapists worldwide. Therefore, it is important to identify whether the therapists have the required knowledge, skills and resources in order to deliver the best evidence-based practice. OBJECTIVES: The main objective of this cross-sectional study is to analyse the self-reported characteristics of behaviour, knowledge, skills and resources, opinion and barriers related to evidence-based practice among cardiopulmonary physical therapists of United Arab Emirates (UAE). METHODS: An electronic questionnaire was circulated among 60 licensed cardiopulmonary physical therapists, of either gender, practicing in UAE with a minimum experience of 1 year via e-mail. The response was further subjected to descriptive analysis. RESULTS: The rate of response was 55% (33/60). The physical therapists of cardiopulmonary disciple reported that they understand the term Evidence Based Practice and frequently update themselves through scientific papers obtained via accessing various databases. Respondents also believe that the exposure in undergraduate or postgraduate course was not sufficient. However, they were also satisfied with amount of discussions taking place regarding EBP at their work place. The barriers commonly reported were difficulty in obtaining full-text papers, lack of time and lack of evidence-based training. CONCLUSION: Thus, concluding that physical therapists from UAE who practiced in cardiopulmonary subdiscipline believe that they have knowledge and skills to use evidence-based practice. Although, they have favourable opinions regarding its application and they still encounter difficulties in implementing it successfully.

Low Physical Activity Levels Are Linked to Early Hypertension Risk in College-Going Young Adults.

Background: Sedentary behaviour and physical inactivity along with body mass are identified as critical determinants of vascular health along with body mass in young adults. However, the relationship between potential physical health and anthropometric variables with high blood Eid pressure remain unexplored in young adults from the United Arab Emirates region. Methodology: We administered a cross-sectional study in young adults assessing their self-reported physical activity levels, anthropometric variables (body mass index and waist circumference) and ambulatory blood pressure. The associations among potential physical health, anthropometric variables and high blood pressure were analysed through logistic regression after necessary transformation. Results: Of 354 participants (176 males, 178 females), we found 17.79% (n = 63) had higher mean arterial pressure. Males (n = 40; 22.73%) had higher risk of hypertension than females (n = 12.92%). Weekly physical activity levels (ß = -0.001; p = 0.002), age (ß = -0.168; p = 0.005) and gender (ß = -0.709; p = 0.028) were found to be more strongly associated with hypertension risk than the body mass index (ß = 0.093; p = 0.075), waist circumference (ß = 0.013; p = 0.588) and the weekly sitting time (ß = 0.000; p = 0.319) of the individuals. Conclusions: Lower physical activity was associated with hypertension risk compared to other modifiable risk factors such as waist circumference, body mass index and sedentary time in college-going young adults. Public health measures should continue to emphasise optimisation of weekly physical activity levels to mitigate vascular health risks at educational institution levels.

Maximal Respiratory Pressures and Maximum Voluntary Ventilation in Young Arabs: Association with Anthropometrics and Physical Activity.

BACKGROUND: Maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and maximum voluntary ventilation (MVV) measurements assist in determining the respiratory muscle strength and endurance. These determinants of respiratory muscles vary significantly by age, gender, height, and ethnic origin. Normative values for maximum respiratory pressures (MRPs) and MVV would aid in evaluating respiratory muscle function in athletes, estimating performance, and assisting in rehabilitation. In addition, the reference values may aid in determining the efficacy of therapeutic interventions in young people with chronic respiratory diseases. The purpose of this study was to see how respiratory muscle strength indices correlated with anthropometric and physical activity characteristics in young Arabs. METHODOLOGY: The study included 80 male volunteers and 85 female volunteers ranging in age from 18 to 30 years. MicroRPM was used to measure MIP and MEP, and pulmonary function test data, including MVV values, were recorded. All subjects completed the Global Physical Activity Questionnaire (GPAQ) and anthropometric measurements. Unpaired t-tests or Mann-Whitney U-tests were used to determine male-female differences. Using the Pearson correlation coefficient and Spearman Rho correlation coefficient tests, MIP and MEP values were correlated with body composition and physical activity. Using stepwise multiple linear regression analysis, the relationships between respiratory function (MVV, MIP, and MEP) and PFT values (FVC, FEV1, and FEV1/FVC), physical activity, and sedentary behavior were investigated. RESULTS: MIP, MEP, and MVV values were significantly lower in females than in males. MIP, MEP, and MVV values had a moderate correlation with forced vital capacity, forced expiratory volume in 1 second, and height, but not with weight, BMI, or GPAQ. Age, gender, and body mass index were found to be significant predictors of maximal respiratory pressures in a young Arab population. CONCLUSION: Maximum respiratory pressures and maximal voluntary ventilation were significantly lower in young Arabs than in other ethnic groups; these values were influenced by gender and height but not by levels of physical activity.

Physiotherapy Practice for Management of Patients Undergoing Upper Abdominal Surgery in United Arab Emirates - A National Survey.

BACKGROUND: The main goal of physiotherapy post-upper abdominal surgery (UAS) is to expedite recovery from the surgery by avoiding or remediating postoperative pulmonary complications (PPCs) and offering physical rehabilitation to ease the process of returning to premorbid status. The present study aimed to survey physiotherapists in the United Arab Emirates (UAE) about their clinical practice in the assessment and management of patients having upper abdominal surgery. METHODS: The current study adopted a novel anonymous online survey to explore the current practice among physiotherapists in the UAE. The Research Ethics Committee approved the study, and a questionnaire was borrowed from a previous study with similar objectives completed in Australia. The questionnaire had 51 questions cutting across 7 sections that investigated the assessment tools and interventions and explored current practice amongst physiotherapists treating patients following abdominal surgery in UAE hospitals. RESULTS: A survey of 42 post-UAS physiotherapy practitioners across the UAE was conducted with a 42% response rate and 57.5% completion rate. The mean age of physiotherapists who were working in the UAE is 35 years, most of whom have more than five years of general ward experience. Most patients were not seen on day zero (day of surgery). Respondents in the UAE are almost universally preferred prescribing deep breathing exercises, incentive spirometry (IS), mobility from the bedside, and education as their primary intervention either "often" or "always" in the consecutive days post-UAS. Spo2, visual analog scale, respiratory rate and fatigue are used as key outcome measures. CONCLUSION: Research work on physiotherapy postoperatively has shown demonstrated prominence of mobilization but is not yet reflected in current practice among physiotherapists caring for post-UAS cohorts in the UAE. The vast difference in the choice of screening tools preferred by physiotherapists in diagnosing high-risk patients postoperatively reflects a lack of corroborating evidence available to physiotherapists.

"We are so close; yet too far": perceived barriers to smartphone-based telerehabilitation among healthcare providers and patients with Chronic Obstructive Pulmonary Disease in India.

BACKGROUND: Telerehabilitation is imperative and impending in the management of chronic obstructive pulmonary disease patients. However, its feasibility in low- and middle-income nations such as India remained unclear. OBJECTIVE: To assess the feasibility of administering a smartphone-based telerehabilitation program for chronic obstructive pulmonary disease patients in India. MATERIAL AND METHOD: An online cross-sectional survey was administered to stakeholders of the telerehabilitation program: chronic obstructive pulmonary disease patients, health care professionals including pulmonary care physicians, rehabilitation nurses and physiotherapists. The survey sought to ascertain the causes, barriers, and facilitators associated with the implementation of smartphone-based telerehabilitation, as well as strategies for practice improvement. RESULTS: While 71% (n = 37/52) of the 52 healthcare professionals surveyed were aware of smartphone-based telerehabilitation, implementation was found to be extremely low (n = 4/37; 10%). The majority of patients with chronic obstructive pulmonary disease (n = 21/30; 70%) agreed to accept smartphone-based telerehabilitation as one of their treatment options. In India, challenges to efficient telerehabilitation implementation included a lack of infrastructure, perceived time consumption, a lack of expertise and training, organizational support, and perceived inefficacy. CONCLUSION: While knowledge of smartphone-based telerehabilitation is high among healthcare professionals and chronic obstructive pulmonary disease patients, implementation of this novel intervention measure has been limited due to perceived constraints associated with smartphone-based telerehabilitation. Adapting national and organizational policies to support smartphone-based telerehabilitation services is critical during this decade of social isolation.

Respiratory Muscle Strength in Healthy Indian Children of Age 7-17 Years: A Cross-Sectional Study.

PURPOSE: As the values of respiratory muscle strength vary according to race, ethnicity, and geographical area, there is a wide-ranging difference among different populations. Thus, the available reference values may not have an application for use in the Indian paediatric population, creating a need for generating values which will be appropriate for the Indian paediatric context. MATERIALS AND METHODS: Assessment of respiratory muscle strength was carried out by assessing maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) and synthesising predictive formulas using anthropometric variables like height, gender and age, which will be suitable for Indian children. RESULTS: We calculated MIP and MEP of 320 (boys=160 and girls= 160) children in the age range of 7 years to 17 years of Mangaluru city, India. Results stated that mean MIP and MEP for boys were 72.5±32.8 cm H2O and 73±33.2 cm H2O, while for the girls it was 67±30.2 cm H2O and 68±30.1 cm H2O, respectively. CONCLUSION: This study concluded that there is a difference in respiratory pressure values of Indian children with respect to those of other countries. Age, gender, height and BMI have a significant role in determining respiratory muscle strength. Boys demonstrated higher MIP and MEP. As age, height, weight and BMI increases, so does MIP and MEP.

Contrasting effects of three breathing techniques on pulmonary function, functional capacity and daily life functional tasks in patients following valve replacement surgery- A pilot randomized clinical trial.

BACKGROUND: Valve replacement surgeries affect the physiological mechanisms of patients leading to various postoperative pulmonary complications. Lung expansion therapy consisting of numerous techniques is routinely used for the prevention and treatment of these complications. OBJECTIVES: Our study aimed to compare the effects of diaphragmatic breathing (DB), flow (FS) and volume-oriented incentive spirometer (VS) in patients following valve replacement surgery. METHODS: 29 patients posted valve replacement surgeries were randomly assigned to VS, FS and DB groups. Patients underwent preoperative training and seven-day rehabilitation post-surgery. Pulmonary function tests were performed before surgery and for seven days afterward. On the seventh postoperative day, patients performed a six-minute walk test and completed a functional difficulties questionnaire (FDQ). RESULTS: Pulmonary function test values reduced in all three groups postoperatively when compared to the preoperative values but improved by the seventh postoperative day (p < 0.05). On comparing the seventh postoperative day values to the preoperative values, the VS group had no significant difference (p = 1.00) (Forced Vital Capacity- % change: DB-37.76, VS-1.59, FS-27.98), indicating that the value had nearly returned to the baseline. As compared to the DB and FS groups, FVC showed a greater improvement in the VS group (p = 0.01 and p = 0.06 respectively). No significant differences were observed between groups for distance walked (p > 0.05), however, FDQ scores demonstrated positive changes in favor of VS when contrasted with FS or DB (p < 0.05). CONCLUSION: Diaphragmatic breathing, flow or volume-oriented spirometer could improve pulmonary function in the postoperative period. The volume-oriented spirometer, however, was found to be the most beneficial among the three techniques in improving patients' pulmonary function and daily life functional tasks. Further research is warranted to confirm these findings.

Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review.

There has been an apparent association between the risks of complications with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with a history of existing chronic respiratory diseases during the pandemic of coronavirus disease 2019 (COVID-19). SARS-CoV-2 poses a severe risk in cardiopulmonary management. Moreover, chronic respiratory diseases may further amplify the risk of morbidity and mortality among the afflicted population in the pandemic era. The present review outlines the importance of pulmonary rehabilitation (PR) in persons with chronic respiratory diseases (Chronic obstructive pulmonary disease (COPD) and Asthma) during the COVID-19 era. In this context, amongst the population with a pre-existing pulmonary diagnosis who have contracted SARS-CoV-2, following initial medical management and acute recovery, exercise-based pulmonary rehabilitation (PR) may play a crucial role in long-term management and recovery. The energy conservation techniques will play a pragmatic role in PR of mild to moderate severity cases to counter post-COVID-19 fatigue. Moreover, there is also an urgent need to effectively address post-COVID-19 anxiety and depression, affecting the PR delivery system.

Effects of three pulmonary ventilation regimes in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial.

The aim was to compare the effect of diaphragmatic breathing exercise (DBE), flow- (FIS) and volume-oriented incentive spirometry (VIS) on pulmonary function- (PFT), functional capacity-6-Minute Walk Test (6 MWT) and Functional Difficulties Questionnaire (FDQ) in subjects undergoing Coronary Artery Bypass Graft surgery (CABG). The purpose of incorporating pulmonary ventilator regimes is to improve ventilation and avoid post-operative pulmonary complications. CABG patients (n = 72) were allocated to FIS, VIS and DBE groups (n = 24 each) by block randomization. Preoperative and postoperative values for PFT were taken until day 7 for all three groups. On 7th postoperative day, 6 MWT and FDQ was analyzed using ANOVA and post-hoc analysis. PFT values were found to be decreased on postoperative day 1(Forced Vital Capacity (FVC) = FIS group-65%, VIS group-47%, DBE group-68%) compared to preoperative day (p < 0.001). PFT values for all 3 groups recovered until postoperative day 7 (FVC = FIS group-67%, VIS group-95%, DBE group-59%) but was found to reach the baseline in VIS group (p < 0.001). When compared between 3 groups, statistically significant improvement was observed in VIS group (p < 0.001) in 6 MWT and FDQ assessment. In conclusion, VIS was proven to be more beneficial in improving the pulmonary function (FVC), functional capacity and FDQ when compared to FIS and DBE.

A Cross-Sectional Study on Balance Deficits and Gait Deviations in COPD Patients.

Background: The gait abnormalities were linked to the balance deficits in the previous studies. However, the deviations in the gait parameters in COPD are currently not known. The study aims to compare gait parameters, static and dynamic balance, and risk of falls in COPD with those in non-COPD individuals. Method: Fourty-two patients with COPD aged 45 years and gender-matched control subjects were included in the study. Gait parameters were assessed by Win-Track gait analyzer, the static balance was assessed by posturography, and the dynamic balance was assessed by the time up and go test. The fear of falls was assessed by Falls Efficacy Scale. Results: COPD individuals had decreased static and dynamic balance as assessed by posturography (p < 0.05) and TUG (p < 0.01), respectively. A significant difference in swing duration (p=0.004) and also increased risk of falls (p < 0.01) was observed in COPD patients as compared to non-COPD individuals. Conclusion: COPD individuals have increased swing duration, reduced static and dynamic balance, and increased fear of falls as compared to non-COPD individuals.

Effectiveness of Hand-Arm Bimanual Intensive Therapy on Hand Function among Children with Unilateral Spastic Cerebral Palsy: A Meta-Analysis.

BACKGROUND: Hand-arm bimanual intensive therapy (HABIT) has been shown to be an effective method for improving upper-extremity function. However, owing to ambiguity within the evidence of HABIT's effects on hand function among children with unilateral spastic cerebral palsy (CP), this meta-analysis sought to elucidate whether the same was true in this patient population. SUMMARY: A computerized database search yielded 468 studies. After meticulous scrutiny and screening of these studies according to the selection criteria, 4 full-text articles were included in the meta-analysis. All 4 studies underwent a methodological quality assessment according to the Physiotherapy Evidence Database Scale (PEDro), with a score of greater than 8. Five comparisons were then made involving the 4 selected randomized controlled trials (RCTs). The effect size was measured using the correlation coefficient (r value). The effect sizes of the individual studies were 0.006, 0.03, 0.04, 0.22, and 0.15. The total effect size was 0.06. Key Message: This meta-analysis determined that there is a trivial benefit using HABIT when compared to constraint-induced movement therapy or structured and unstructured bimanual therapy in pediatric patients with unilateral spastic CP. More RCTs are needed to substantiate our evidence.

Telerehabilitation for Chronic Obstructive Pulmonary Disease Patients: An Underrecognized Management in Tertiary Care.

Pulmonary rehabilitation (PR) is proved to be best supportive management in chronic obstructive pulmonary disease (COPD) individuals. The literature claims the reduction of dyspnea, fatigue, exacerbations, and improved functional capacity and quality of life. Home-based PR is being prescribed widely than hospital-based rehab due to be less cost and ease of caregiver burden, but efficacy is usually questioned. The poor efficacy may be probably due to recurrent exacerbation and poor quality of life even after years of home rehabilitation. Telerehabilitation is an excellent rehab measure where the COPD patients exercise at his home, while expertise from the tertiary care centers monitors the rehab sessions remotely. In India, the tele-PR is at its budding state. This review shall enable the readers with the basics of telerehabilitation in comparison with the other available rehab measures and evidence in the management of COPD.

Effect of aerobic exercise on echocardiographic epicardial adipose tissue thickness in overweight individuals.

BACKGROUND: Epicardial adipose tissue thickness (EATT) measured by echocardiography is a reliable indicator of visceral adipose tissue in the body and metabolic syndrome. The objective of this work was to study the effect of 12-week aerobic exercise training on echocardiographic epicardial adipose tissue thickness (EEATT), body composition and other metabolic parameters in asymptomatic overweight adults. METHODS: A total of 170 overweight and mild obese individuals were randomly allocated to 12-week aerobic exercise program (intervention group) or no supervised exercise (control group). The body fat percentage and visceral fat levels were measured by bioelectric impedance analyzer, and blood tests were conducted to measure lipids, fasting blood sugar (FBS) and high-sensitivity C-reactive protein (Hs-CRP). The participants also underwent transthoracic echocardiography to measure EATT. All the outcomes were measured after 12 weeks. Repeated measures were analyzed using ANOVA and Mann-Whitney U-test were used to analyze the data. RESULTS: EEATT values significantly reduced by -16.24% (3.12±1.18 to 2.70±1.04, p<0.05) following 12 weeks of aerobic exercise along with a reduction in weight by 2.96% (80.66±12.12 to 78.27±12.31, p<0.05), body mass index by 3.11% (29.20±2.71 to 28.29±2.81, p<0.05) and waist circumference by 2.29% (94.82±7.23 to 92.64±7.33, p<0.05) and improved Hs-CRP values. CONCLUSION: The 12-week aerobic exercise was found to be effective in reducing EEATT in overweight and mild obese individuals. There was significant improvement in body composition, blood lipids, FBS, Hs-CRP and exercise capacity in intervention group compared to control group.