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1. Reproducibility of improvements in patient-reported functional ability following functional capacity evaluation

Author

Martin Schindl, Harald Zipko, and Matthias Bethge

Subjects
Trauma, Rehabilitation, Return to work, Functional capacity evaluation, Cohort study, Replication, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background Performance of functional capacity evaluation (FCE) may affect patients, self-efficacy to complete physical activity tasks. First evidence from a diagnostic before-after study indicates a significant increase of patient-reported functional ability. Our study set out to test the reproducibility of these results. Methods Patients with musculoskeletal trauma and an unclear return to work prognosis were recruited in a trauma rehabilitation center in Lower Austria. We included patient cohorts of three consecutive years (2016: n = 161, 2017: n = 140; 2018: n = 151). Our primary outcome was patient-reported functional ability, measured using the Spinal Function Sort (SFS). SFS scores were assessed before and after performing an FCE to describe the change in patient-reported functional ability (cohort study). We investigated whether the change in SFS scores observed after performing an FCE in our first cohort could be replicated in subsequent cohorts. Results Demographic data (gender, age and time after trauma) did not differ significantly between the three patient cohorts. Correlation analysis showed highly associated before and after SFS scores in each cohort (2016: rs = 0.84, 95% CI: 0.79 to 0.89; 2017: rs = 0.85, 95% CI: 0.81 to 0.91; 2018: rs = 0.86, 95% CI: 0.82 to 0.91). Improvements in SFS scores were consistent across the cohorts, with overlapping 95% confidence intervals (2016: 14.8, 95% CI: 11.3 to 18.2; 2017: 14.8, 95% CI: 11.5 to 18.0; 2018: 15.2, 95% CI: 12.0 to 18.4). Similarity in SFS scores and SFS differences were also supported by non-significant Kruskal–Wallis H tests (before FCE: p = 0.517; after FCE: p = 0.531; SFS differences: p = 0.931). Conclusions A significant increase in patient-reported functional ability after FCE was found in the original study and the results could be reproduced in two subsequent cohorts.

Published
2022
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2. Effects of inspiratory muscle training on dynamic hyperinflation in patients with COPD

Author

Milos Petrovic, Theodor Wanke, Harald Zipko, Wolfgang Pohl, and Michael Reiter

Subjects
Male, medicine.medical_specialty, Time Factors, Respiratory rate, cycle ergometer test, International Journal of Chronic Obstructive Pulmonary Disease, Work rate, Breathing Exercises, chronic obstructive pulmonary disease, Pulmonary Disease, Chronic Obstructive, Work of breathing, Endurance training, Internal medicine, medicine, Humans, Dynamic hyperinflation, Lung, Original Research, Aged, Work of Breathing, lcsh:RC705-779, COPD, inspiratory muscle training, Exercise Tolerance, business.industry, dynamic hyperinflation, Recovery of Function, lcsh:Diseases of the respiratory system, General Medicine, dyspnea, Middle Aged, medicine.disease, Respiratory Muscles, Respiratory Function Tests, Treatment Outcome, Inhalation, Austria, Exercise Test, Cardiology, Physical therapy, Breathing, Female, business, Respiratory minute volume
Abstract

Milos Petrovic,1 Michael Reiter,2 Harald Zipko,3 Wolfgang Pohl,1 Theodor Wanke11Pulmonary Department and Karl Landsteiner Institute for Clinical and Experimental Pulmology, Hietzing Hospital, Vienna, Austria; 2Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria; 3FH Campus Vienna, University of Applied Sciences – Health Department, Vienna, AustriaAbstract: Dynamic hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT). The aim of the study was to analyze the effects of IMT on exercise capacity, dyspnea, and inspiratory fraction (IF) during exercise in patients with COPD. Daily inspiratory muscle strength and endurance training was performed for 8 weeks in 10 patients with COPD GOLD II and III. Ten patients with COPD II and III served as a control group. Maximal inspiratory pressure (Pimax) and endurance time during resistive breathing maneuvers (tlim) served as parameter for inspiratory muscle capacity. Before and after training, the patients performed an incremental symptom limited exercise test to maximum and a constant load test on a cycle ergometer at 75% of the peak work rate obtained in the pretraining incremental test. ET was defined as the duration of loaded pedaling. Following IMT, there was a statistically significant increase in inspiratory muscle performance of the Pimax from 7.75 ± 0.47 to 9.15 ± 0.73 kPa (P < 0.01) and of tlim from 348 ± 54 to 467 ± 58 seconds (P < 0.01). A significant increase in IF, indicating decreased dynamic hyperinflation, was observed during both exercise tests. Further, the ratio of breathing frequency to minute ventilation (bf/V'E) decreased significantly, indicating an improved breathing pattern. A significant decrease in perception of dyspnea was also measured. Peak work rate during the incremental cycle ergometer test remained constant, while ET during the constant load test increased significantly from 597.1 ± 80.8 seconds at baseline to 733.6 ± 74.3 seconds (P < 0.01). No significant changes during either exercise tests were measured in the control group. The present study found that in patients with COPD, IMT results in improvement in performance, exercise capacity, sensation of dyspnea, and improvement in the IF prognostic factor.Keywords: chronic obstructive pulmonary disease, cycle ergometer test, dynamic hyperinflation, dyspnea, inspiratory muscle training

Published
2012
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