The objective of this study was to assess the oxygen cost of various intensities of steady-state cycling. VO2 (ml·min -1·kg-1) was measured at rest, during unloaded cycling (UL), 20 Watts, 50% (SS50) & 65% (SS65) of peak watts in 40 COPD patients (64 +/- 9 yrs; FEV1/FVC: 48 +/- 17 % predicted; FEV1:36 +/- 14 % predicted) and 28 age-matched healthy controls (CTRL). Despite higher VE (L·min -1) in COPD vs. CTRL (UL: 20.6 +/- 3.4 vs. 15.4 +/- 4.1; 20W: 24.3 +/- 4.5 vs. 17.8 +/- 4.2), VO2 at rest, at UL and 20W was not higher in COPD compared to CTRL. In addition, comparable slope and intercept coefficients for the VO2 vs. Watt relationship were obtained in COPD and CTRL for submaximal cycling of low to moderate intensity. (Abstract shortened by UMI.)

To date, there is a scant amount of research on the long-term benefits of exercise training for individuals with moderate to severe chronic obstructive pulmonary disease. The purpose of this study was to evaluate standardized outcomes of a six-month maintenance pulmonary rehabilitation program to determine maintenance of functional capacity. Twenty-three subjects (sixteen men, seven women) diagnosed with clinical COPD ages 30-82 (65 + 12 years) participated in the retrospective study. The subjects were referred to an eight-week comprehensive pulmonary rehabilitation program after which upon twelve subjects continued onto a maintenance program. Eleven subjects chose not to participate in the maintenance program and were given a home exercise program and were encouraged to remain active. Hemodynamic, functional, and educational measures were taken prior to entry, upon completion of the hospital program, and again six-months post-program. Outcome tests were standardized using the Indiana Society of Cardiovascular and Pulmonary Rehabilitation Outcomes Manual. Significant differences were found between the maintenance and non-maintenance groups for systolic blood pressure in resting, exercise, and recovery measures at six monthsreevaluation. Differences in oxygen saturation were also found to reach significance between the two groups during recovery from the six-minute walk test. Interestingly, duration of exercise was found to be statistically significant between the two groups as well as emergency room visits and physician visits within the last six months. The maintenance group tended to have fewer emergency room and physician visits in addition to having self-reported higher durations of exercise. In conclusion, maintenance pulmonary rehabilitation programs have been shown to maintain physical activity levels for COPD patients and as a result, fewer quality of life consequences specifically the number of hospital admissions and emergency room visits. / School of Physical Education

No description available.

Hospital readmission is prevalent among people with chronic obstructive pulmonary disease (COPD), particularly among older people in Hong Kong. Evidence shows that hospital readmissions exert a considerable impact on patients. Studies in this area primarily identify various associative factors based on the perspectives of health professionals. However, these factors are inadequate in illustrating the needs of older people and in illuminating the phenomenon of hospital readmissions. A thorough understanding of the issue can be achieved if the related experiences are interpreted from the perspective of the patients and in terms of their context. Understanding of their experiences has paramount significance in uncovering the unmet needs of patients and in informing the provision of healthcare services. Yet, there is a dearth of studies unfolding the experiences of Chinese older people. / This study aimed to explore and describe the lived experience of hospital readmissions of Chinese older people with COPD and to identify Chinese socio-cultural influences on the experience. Understanding was acquired through descriptive phenomenology. Twenty-two Chinese older people aged 62 to 89 were recruited by purposive sampling. They had been readmitted 4 to 14 times in the previous year. The older people were interviewed once during their hospitalization, and their readmission experiences were elicited from these unstructured interviews. Narrative descriptions were analyzed using the phenomenological method described by Giorgi (1985). / The general structure of the lived experience of hospital readmissions of Chinese older people with COPD reveals that older people refrain from unnecessary readmissions because they regard hospital care as the last resort in relieving breathlessness. When their breathlessness becomes intolerable, they perceive the urgency of surviving the distress. Craving for survival, they seek hospital readmission, which provides them immediate relief from the imminent threat. After being readmitted to a hospital, they feel powerless when their need for hospital care is disregarded by their doctors. Considering themselves as demanding to their families in daily lives, older people remain conscious of relieving their burden during their periods of hospital readmission because they regard this as the only opportunity to relieve their burden. Older people come to realize hospital readmissions are unavoidable after they put every effort to refrain from it but hospital care remains necessary. They further rationalize hospital readmissions as inevitable and resign themselves to it because of their perception of aging, doctors’ accounts of COPD, experience with and knowledge of the disease, and belief in fate. This acceptance of the inevitability of hospital readmissions precipitates an attitudinal shift toward the belief of living for the moment. Their past experiences inspire them to be satisfied with the current state of living and engage the present. This positive outlook enables them to embrace the experiences of hospital readmissions into their lives. Six invariant constituents emerged from the lived experience. The constituent “refraining from unnecessary readmissions” describes how older people manage their diseases in relation to hospital readmissions. “Craving for survival” explains why they seek hospital readmissions. “Feeling being disregarded and powerless” and “being conscious of relieving burden to families” characterize their experience of hospital readmissions. “Resigning to hospital readmissions” illustrates how they understand the recurrence of this phenomenon and “living for the moment” illuminates how they live with their experiences. / A deep understanding of hospital readmissions is embodied in the experiences of older people. The findings emphasize that hospital readmissions among Chinese older people are complex experiences shaped by their sociocultural context. The meanings of hospital readmissions to older people are influenced by their assumption of a submissive patient role, collectivism, external attribution style, and past life experiences. Although older people appear to accept and cope well with hospital readmissions, this study uncovers their needs as they move to and fro the hospital and home. The findings of this study offer implications in promoting the wellness of Chinese older people as they go through this revolving door. / 再次住院在患有慢性阻塞性肺病人士中相當普遍，尤其是在中國老年患者。研究證據顯示再次住院對病人有很大的影響。現有的研究偏重於從醫務人員角度尋找不同的關聯因素，但該些因素並不足以反映老年人的需要以及解釋再次住院的現象。只有透過病人的觀點以及結合他們的背景來闡釋這些相關經驗，才能作出深入了解。了解病人的再次住院經驗有助於找出病人的需要以及指引醫療服務的提供。然而，有關中國老年人再次住院經驗的探討相當缺乏。 / 是次研究目的是探討和描述患有慢性阻塞性肺病的中國老年人再次住院的體驗，以及認識中國社會文化對再次住院經驗的影響。研究採用描述現象學方法。研究以立意抽樣方式選取了22名62至89歲的中國老年人。他們在去年入院次數為4至14次。這些老年人在住院期間均接受一次非結構式訪談以了解他們的再次住院經驗。這些敘述性描寫再按 Giorgi (1985) 的現象學方法作出分析。 / 患有慢性阻塞性肺病中國老年人再次住院的體驗的通用結構顯示他們避免不必要的再次住院，因為他們將住院護理視為紓緩呼吸困難的最後方法。當他們的呼吸困難惡化至無法忍受，他們會感受到從危病中活下來的迫切性。因著渴望生存的意識，他們尋求再次住院以即時消除緊迫的生命威脅。再次入院後，對於醫生漠視其住院護理的需要，他們感到無力。由於考慮到他們在日常生活中對家人的需求頗多，老年人以再次住院其間來減輕家庭負擔，因他們視這其間為唯一能減輕家庭負擔的機會。儘管老年人盡能力以避免再次入院，但他們依然需要住院護理，老年人逐漸意識到再次住院為無可避免。由於老年人對於老化的感知、醫生對慢性阻塞性肺病的解明、患病經驗和對疾病的相關知識以及相信命運的看法，他們更將再次住院合理化為無可避免並順從。接受再次住院為無可避免促成他們的態度轉變為活在當下。過去的經驗令他們對目前的生活感到滿意並希望活在當下。這個正面想法令他們將再次住院接納為生活的一部份。六個不變組成要素呈現於老年人的再次住院體驗當中。組成要素「避免不必要的再次住院」描述老年人如何管理慢性阻塞性肺病以避免再次住院。「渴望生存」解釋了他們尋求再次住院的原因。「感到被忽略和無力」以及「減輕家庭負擔的意識」敘述了他們再次住院的經驗。「順從再次住院」說明了他們對再次住院現象發生的理解，而「活在當下」說明了他們如何接納再次住院經驗。 / 對於再次住院的深入了解具體表現於老年人的經驗當中。是次研究結果強調，老年人再次住院是由他們的社會文化背景塑造而成的複雜經驗。對於老年人而言，再次住院的意義受到他們對順從性病人角色的假設、集體主義觀念、外部歸因以及過往的生活經驗所影響。雖然老年人似乎接受並適應再次住院，是次研究發現了他們在這現象中的需要。研究結果對於促進再次住院的中國老年人的健康帶來新的啟示。 / Tang, Wing Ki. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2015. / Includes bibliographical references (leaves 342-393). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Thesis (PhD (Sport Science))--Stellenbosch University, 2008. / The benefits of exercise training for patients with chronic obstructive pulmonary disease (COPD) are well-documented. In South Africa, exercise programmes for COPD patients are limited and often expensive and inaccessible to the broader community. The purpose of this study was to assess the responses of COPD patients to an exercise programme and to determine if the same results can be obtained through a less costly programme. In the primary programme of the study, 22 subjects were subjected to 12 weeks of exercise training. Each subject underwent comprehensive pre- and post-intervention assessments, which included the measurement of overall health status by a physician, level of dyspnoea, forced expiratory lung function, exercise capacity, body mass index and health-related quality of life. Exercise sessions included aerobic and strength training exercises and involved three, hour-long exercise sessions a week. In the modified programme, 18 subjects were randomly divided into an experimental and control group. Eleven subjects were included in the experimental group and seven subjects in the control group. Subjects had to complete 32, hour-long exercise sessions in a 10-week period. The experimental group’s exercise programme was adapted so that no specialised equipment was used, while the control group exercised in a well-equipped exercise- and rehabilitation centre.

Thesis (MScSportSc)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The purpose of the study was to measure the responses of chronic obstructive pulmonary disease patients to an exercise programme in a South Africa setting. Nine subjects were evaluated before and after aerobic and resistance training three times a week for the total of 12 weeks. Each evaluation measured forced expiratory lung function; health-related quality of life; functional capacity; level of dyspnea; body composition; physician global evaluation; and the patient global evaluation. The exercise programme consisted of one-hour exercise sessions, three times a week for 12 weeks. The exercise sessions included elements of aerobic and resistance training of the upper and lower extremities. Functional capacity improved drastically (p < 0.01), as did the physician and the patient global evaluations (p < 0.01 and p < 0.01, respectively). Levels of dyspnea also improved (p < 0.01). Health-related quality of life improved marginally (p = 0.03). No significant change was noted in lung function and body composition. The study concluded that an exercise programme consisting of aerobic and resistance training improves chronic obstructive pulmonary disease patients' health-related quality of life, functional capacity and levels of dyspnea. Exercise also reduces the symptoms of chronic obstructive pulmonary disease as are perceived by the physician and patient alike. Exercise does not change lung function or body composition of chronic obstructive pulmonary disease patients. Exercise in conjunction with appropriate medical treatment has the potential to benefit all chronic obstructive patients in South Africa. Keywords: COPD, quality oflife, functional capacity, rehabilitation, exercise. / AFRIKAANSE OPSOMMING: Die doel van die studie was om die reaksies te meet van pasiënte met chroniese obstruktiewe pulmonêre siekte op 'n oefenprogram in 'n Suid-Afrikaanse konteks. Nege proefpersone is voor en na aërobiese en weerstandsoefening drie keer per week vir 'n totaal van 12 weke geëvalueer. Elke evaluering het die volgende gemeet: geforseerde ekspiratoriese longfunksie, gesondheidsverwante lewenskwalitiet, funksionele kapasiteit; dispneevlak, liggaamsamestelling; geneesheer algehele evaluering asook pasiënt algehele evaluering. Die oefenprogram het uit een-uur sessies bestaan, wat drie keer per week vir 12 weke plaasgevind het. Die oefensessies het elemente van aërobiese en weerstandsoefeninge van die boonste en onderste ledemate ingesluit. Funksionele kapasiteit het drasties verbeter (p < 0.01), net so ook die geneesheer en pasiënt algehele evaluerings (p < 0.01 en p < 0.01, respektiewelik). Dispneevlakke het ook verbeter (p < 0.01). Gesondheidsverwante lewenskwaliteit het marginaal verbeter (p = 0.03). Geen beduidende veranderinge is in die longfunksie en liggaamsamestelling gevind nie. Die studie het bevind dat 'n oefenprogram wat uit aërobiese en weerstandsoefening bestaan gesondheidsverwante lewenskwaliteit, funksionele kapasiteit asook dispneevlakke van pasiënte met chroniese obstruktiewe pulmonêre siekte verbeter. Oefening verminder ook die simptome van chroniese obstruktiewe pulmonêre siekte soos waargeneem deur beide die geneesheer en pasiënt. Oefening verander ook nie longfunksie of liggaamsamestelling van pasiënte met chroniese obstruktiewe pulmonêre siekte nie. Oefening tesame met die geskikte mediese behandeling kan voordelig wees vir chronies obstruktiewe pasiënte in Suid- Afrika. Keywords: KOPS, lewenskwaliteit, funksionele kapasiteit, rehabilitasie, oefening.

University of Macau / Institute of Chinese Medical Sciences