Effects of complementary whole-body vibration training in patients after lung transplantation: A randomized, controlled trial.

BACKGROUND: In recent years, some studies have shown that whole-body vibration training (WBVT) may be a beneficial training mode in patients with chronic obstructive pulmonary disease (COPD). However, the effects of WBVT in patients after lung transplantation (LTx) have not yet been investigated. METHODS: Eighty-three LTx patients (56 ± 7 years of age, 51% male, 10 ± 12 weeks post-LTx, forced expiratory volume in 1 second [FEV1] 68 ± 20 percent predicted [% pred], baseline 6-minute walk distance [6MWD] 350 ± 120 meters) admitted to a 4-week inpatient multidisciplinary program of pulmonary rehabilitation (PR) performed supervised endurance and strength training on 5 days per week. In addition, patients were randomly assigned to 1 of 2 supervised intervention groups on 3 days/week: (1) 4 × 2 minutes of bilateral dynamic squat exercises on a side-alternating vibration platform at 24 to 26 Hz (WBVT); and (2) a control group (CON) with the same amount of exercise time on the floor. RESULTS: Seventy patients completed the study (WBVT: n = 34; CON: n = 36). Improvement in 6MWD was significantly (p = 0.029) higher in the WBVT group (83.5 meters [95% CI 65.4 to 101.7]) compared with the CON group (55.2 m [95% CI 37.5 to 72.8]). Also, peak work rate increased significantly (p = 0.042) more in the WBVT group (16.8 W [95% CI 13.5 to 20.5]) than in the CON group (12.6 W [95% CI 9.0 to 16.1]). No adverse events related to the intervention occurred during the study. CONCLUSIONS: A complementary WBVT on top of conventional endurance and strength training seems to be a feasible and safe exercise modality in patients after LTx. Furthermore, it may even enhance the benefits of a comprehensive PR on exercise capacity.

Validation of an activity monitor during sleep in patients with chronic respiratory disorders.

INTRODUCTION: Objective of this study was to validate an activity monitor (DynaPort MoveMonitor [MM], McRoberts, The Hague, The Netherlands) against night-vision video analysis during sleep. METHODS: Twenty patients (65 ± 11 years old, mean body-mass-index: 27 ± 6 kg/m(2)) with different chronic lung diseases were recruited to participate in this validation study. Patients performed a polysomnography measurement during one single night while wearing the MM. The activity monitor data of the MM were then validated against the analysis of the night-vision video by an independent investigator. In total, four different lying positions (supine, left, right and prone), sitting upright, out of bed as well as large, medium, small and sitting transitions were classified. RESULTS: A mean duration of 7.6 ± 0.9 h per night of video and MM classification was available for analysis. In total, 702 different postures were registered on the video from which 678 postures (96.6%) were detected correctly by the MM compared to the video classification. These results yielded a total degree of sensitivity of 93.9% and specificity 94.9% in detecting postures during the night. In total, 682 transitions (394 small, 189 medium, 15 large and 84 sitting transitions) were detected of which 482 were also detected by the MM. The MM detected 70% of the transitions correctly (51.0% small, 97.4% medium, 100% large and 97.6% sitting transitions). CONCLUSION: The MM is an activity monitor showing a high degree of sensitivity and specificity to detect different nocturnal postures as well as medium and large sized transitions in patients with chronic respiratory disorders.

Benefits of an oxygen reservoir cannula versus a conventional nasal cannula during exercise in hypoxemic COPD patients: a crossover trial.

BACKGROUND: The Oxymizer® is a special nasal cannula that provides a higher luminal diameter in combination with an incorporated oxygen (O2) reservoir. It is assumed that a higher O2 concentration can be delivered breath by breath in order to increase oxygenation. OBJECTIVE: We aimed to investigate the effects of the Oxymizer on endurance time in comparison to a conventional nasal cannula (CNC). METHODS: Forty-three patients with severe chronic obstructive pulmonary disease (COPD, age 60 ± 9 years, FEV1 37 ± 16% pred.) and indications for LTOT were recruited during pulmonary rehabilitation for this cross-over study. After an initial maximal incremental cycle test, all patients performed 4 cycling endurance time tests at 70% of their peak work rate (twice with the Oxymizer and twice with a CNC, in reverse order). RESULTS: The endurance time was significantly higher when patients cycled while using the Oxymizer in comparison to while using the CNC [858 ± 754 vs. 766 ± 652 s; between-group difference 92 s (95% confidence interval 32-152), p < 0.001]. In addition to a longer cycling duration, O2 saturation at isotime was significantly higher with the Oxymizer (93.5 ± 5.4 vs. 90.4 ± 5.3%; p = 0.027). Furthermore, there was a positive correlation (r = 0.427, p = 0.002) between the O2 flow rate and improvements in the constant work rate test, showing greater improvements in favor of the Oxymizer in patients with a higher demand for O2 (≥ 4 liters/min). CONCLUSION: We show that O2 delivery via the Oxymizer is superior to a CNC with regard to endurance capacity and oxygenation during exercise in patients with severe COPD. It seems that patients with a higher demand for O2 (≥ 4 liters/min), in particular, may benefit more from the use of the Oxymizer.