Systematic Reviews and Meta Analysis
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Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent?

Year 2022, Volume: 75 Issue: 2, 295 - 302, 30.06.2022

Abstract

Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspnea, reduced exercise capacity, and impaired
quality of life. The aim of our study was to investigate the effectiveness of pulmonary rehabilitation (PR) in patients with KS and in which patients
the gainings are prominent.

Materials and Methods: Forty-six patients who were diagnosed as KS and completed a multidisciplinary comprehensive supervised outpatient
PR program were evaluated. Pulmonary functions, body composition, exercise capacity, respiratory and peripheral muscle strength, quality of life,
psychological states were assessed before and after the PR program. The data of the patients were reviewed retrospectively.

Results: After the PR program, statistically significant differences were observed in Medical Research Council (MRC) levels, Borg, incremental
shuttle walking test, endurance shuttle walking test, six minutes walk test, maximal inspiratory pressure, maximal expiratory pressure, hand grip
test, deltoid and quadriceps 1-repetition maximum tests, St. George Respiratory Questionnaire (SGRQ), chronic respiratory diseases questionnaire,
hospital anxiety and depression scores (HAD-anxiety/depression). There was a statistically significant negative correlation between the initial FEV1
and the gain in anxiety. We also found a statistically significant negative correlation between the initial MRC, SGRQ, anxiety values and the gainings
in depression data.

Conclusion: After multidisciplinary comprehensive PR program, there was an improvement in perception of dyspnea, muscle strengths, exercise
capacities, quality of life, anxiety and depression scores. Our results indicate that the most prominent gainings were in the early stages of the disease.

Ethical Statement

Ethics Ethics Committee Approval: The University of Health Sciences Turkey, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital Ethics Committee, has approved the study (dated: 15.10.2020 and numbered 697-5). Informed Consent: The informed consent was obtained from the patients. Peer-reviewed: Externally peer-reviewed.

References

  • 1. Pajdziński M, Młynarczyk P, Miłkowska-Dymanowska J, et al. Kyphoscoliosis -What Can We Do for Respiration Besides NIV? Adv Respir Med. 2017;85:352-358.
  • 2. Cejudo P, López-Márquez I, Lopez-Campos JL, et al. Factors associated with quality of life in patients with chronic respiratory failure due to kyphoscoliosis. Disabil Rehabil. 2009;31:928-934.
  • 3. Kesten S, Garfinkel SK, Wright T, et al. Impaired exercise capacity in adults with moderate scoliosis. Chest. 1991;99:663-666.
  • 4. McMaster MJ, Glasby MA, Singh H, et al. Lung function in congenital kyphosis and kyphoscoliosis. J Spinal Disord Tech. 2007;20:203-208.
  • 5. Fuschillo S, De Felice A, Gaudiosi C, et al. Nocturnal mechanical ventilation improves exercise capacity in kyphoscoliostic patients with respiratory impairment. Monaldi Arch Chest Dis.2003;59:281 286.
  • 6. Brooks D, De Rosie J, Mousseau M, et al. Long term follow-up of ventilated patients with thoracic restrictive or neuromuscular disease. Can Respir J. 2002;9:99-106.
  • 7. Buyse B, Meersseman W, Demedts M. Treatment of chronic respiratory failure in kyphoscoliosis: oxygen or ventilation? Eur Respir J. 2003;22:525-528.
  • 8. Gonzalez C, Ferris G, Diaz J, et al. Kyphoscoliotic ventilatory insufficiency, Effects of long-term intermittent positive-pressure ventilation. Chest. 2003;124:857-862.
  • 9. Gustafson T, Franklin KA, Midgren B, et al. Survival of patients with kyphoscoliosis receiving mechanical ventilation or oxygen at home. Chest. 2006;130:1828-1833.
  • 10. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/ European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:13-64.
  • 11. Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society, Statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173:1390-1413.
  • 12. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319-338.
  • 13. American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166:518-624.
  • 14. Singh SJ, Jones PW, Evans R, et al. Minimum clinically important improvement for the incremental shuttle walking test. Thorax. 2008;63:775-777.,
  • 15. Pepin V, Laviolette L, Brouillard C, et al. Significance of changes in endurance shuttle walking performance. Thorax. 2011;66:115-120.
  • 16. Jones PW, Quirk FH, Baveystock CM, et al. A Self-Complete Measure of Health Status for Chronic Airflow Limitation, The St, George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992;145:1321-1327.
  • 17. Guyatt GH, Berman LB, Townsend M, et al. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987;42:773-778.
  • 18. Fletcher CM. Standardised questionnaire on respiratory symptoms: a statement prepared and approved by the MRC Committee on the Aetiology of Chronic Bronchitis (MRC breathlessness score). Br Med J. 1960;2:1665.
  • 19. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361-370.
  • 20. Papaliodis DN, Bonanni PG, Roberts TT, et al. Computer Assisted Cobb Angle Measurements: A novel algorithm. Int J Spine Surg. 2017;11:21.
  • 21. Conti G, Rocco M, Antonelli M, et al. Respiratory system mechanics in the early phase of acute respiratory failure due to severe kyphoscoliosis. Intensive Care Med. 1997;23:539-544.
  • 22. Fuschillo S, De Felice A, Martucci M, et al. Pulmonary rehabilitation improves exercise capacity in subjects with kyphoscoliosis and severe respiratory impairment. Respir Care. 2015;60:96-101.
  • 23. Jones DJ, Paul EA, Bell JH, et al. Ambulatory oxygen therapy in stable kyphoscoliosis. Eur Respir J. 1995;8:819-823.
  • 24. Rokach A, Romem A, Arish N, et al. The Effect of Pulmonary Rehabilitation on Non-chronic Obstructive Pulmonary Disease Patients. Isr Med Assoc J. 2019;21:326-329.
  • 25. Cejudo P, López-Márquez I, López-Campos JL, et al. Exercise Training in Patients With Chronic Respiratory Failure Due to Kyphoscoliosis: A Randomized Controlled Trial. Respir Care. 2014;59:375-382.
  • 26. Lisboa C, Moreno R, Fava M, et al. Inspiratory muscle function in patients with severe kyphoscoliosis. Am Rev Respir Dis. 1985;132:48-52.
  • 27. Swallow EB, Barreiro E, Gosker H, et al. Quadriceps muscle strength in scoliosis. Eur Respir J. 2009;34:1429-1435.
  • 28. Wind AE, Takken T, Helders PJM, et al. Is grip strength a predictor for total muscle strength in healthy children, adolescents, and young adults? Eur J Pediatr. 2010;169:281-287.
  • 29. López-Campos JL, Cejudo P, Ortega F, et al. Shuttle walking versus maximal cycle testing: clinical correlates in patients with kyphoscoliosis. Respir Physiol Neurobiol. 2008;160:334-340.
  • 30. Naji NA, Connor MC, Donnelly SC, et al. Effectiveness of pulmonary rehabilitation in restrictive lung disease. J Cardiopulm Rehabil. 2006;26:237- 243.

Kifoskolyozisli Hastalarda Kapsamlı Pulmoner Rehabilitasyonun Etkinliği; Hangi Hastalarda Kazanımlar Belirgindir?

Year 2022, Volume: 75 Issue: 2, 295 - 302, 30.06.2022

Abstract

Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspnea, reduced exercise capacity, and impaired
quality of life. The aim of our study was to investigate the effectiveness of pulmonary rehabilitation (PR) in patients with KS and in which patients
the gainings are prominent.

Materials and Methods: Forty-six patients who were diagnosed as KS and completed a multidisciplinary comprehensive supervised outpatient
PR program were evaluated. Pulmonary functions, body composition, exercise capacity, respiratory and peripheral muscle strength, quality of life,
psychological states were assessed before and after the PR program. The data of the patients were reviewed retrospectively.
Results: After the PR program, statistically significant differences were observed in Medical Research Council (MRC) levels, Borg, incremental
shuttle walking test, endurance shuttle walking test, six minutes walk test, maximal inspiratory pressure, maximal expiratory pressure, hand grip
test, deltoid and quadriceps 1-repetition maximum tests, St. George Respiratory Questionnaire (SGRQ), chronic respiratory diseases questionnaire,
hospital anxiety and depression scores (HAD-anxiety/depression). There was a statistically significant negative correlation between the initial FEV1
and the gain in anxiety. We also found a statistically significant negative correlation between the initial MRC, SGRQ, anxiety values and the gainings
in depression data.

Conclusion: After multidisciplinary comprehensive PR program, there was an improvement in perception of dyspnea, muscle strengths, exercise
capacities, quality of life, anxiety and depression scores. Our results indicate that the most prominent gainings were in the early stages of the disease.

Ethical Statement

centers without waiting for deterioration. Ethics Ethics Committee Approval: The University of Health Sciences Turkey, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital Ethics Committee, has approved the study (dated: 15.10.2020 and numbered 697-5). Informed Consent: The informed consent was obtained from the patients. Peer-reviewed: Externally peer-reviewed.

References

  • 1. Pajdziński M, Młynarczyk P, Miłkowska-Dymanowska J, et al. Kyphoscoliosis -What Can We Do for Respiration Besides NIV? Adv Respir Med. 2017;85:352-358.
  • 2. Cejudo P, López-Márquez I, Lopez-Campos JL, et al. Factors associated with quality of life in patients with chronic respiratory failure due to kyphoscoliosis. Disabil Rehabil. 2009;31:928-934.
  • 3. Kesten S, Garfinkel SK, Wright T, et al. Impaired exercise capacity in adults with moderate scoliosis. Chest. 1991;99:663-666.
  • 4. McMaster MJ, Glasby MA, Singh H, et al. Lung function in congenital kyphosis and kyphoscoliosis. J Spinal Disord Tech. 2007;20:203-208.
  • 5. Fuschillo S, De Felice A, Gaudiosi C, et al. Nocturnal mechanical ventilation improves exercise capacity in kyphoscoliostic patients with respiratory impairment. Monaldi Arch Chest Dis.2003;59:281 286.
  • 6. Brooks D, De Rosie J, Mousseau M, et al. Long term follow-up of ventilated patients with thoracic restrictive or neuromuscular disease. Can Respir J. 2002;9:99-106.
  • 7. Buyse B, Meersseman W, Demedts M. Treatment of chronic respiratory failure in kyphoscoliosis: oxygen or ventilation? Eur Respir J. 2003;22:525-528.
  • 8. Gonzalez C, Ferris G, Diaz J, et al. Kyphoscoliotic ventilatory insufficiency, Effects of long-term intermittent positive-pressure ventilation. Chest. 2003;124:857-862.
  • 9. Gustafson T, Franklin KA, Midgren B, et al. Survival of patients with kyphoscoliosis receiving mechanical ventilation or oxygen at home. Chest. 2006;130:1828-1833.
  • 10. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/ European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:13-64.
  • 11. Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society, Statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173:1390-1413.
  • 12. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319-338.
  • 13. American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166:518-624.
  • 14. Singh SJ, Jones PW, Evans R, et al. Minimum clinically important improvement for the incremental shuttle walking test. Thorax. 2008;63:775-777.,
  • 15. Pepin V, Laviolette L, Brouillard C, et al. Significance of changes in endurance shuttle walking performance. Thorax. 2011;66:115-120.
  • 16. Jones PW, Quirk FH, Baveystock CM, et al. A Self-Complete Measure of Health Status for Chronic Airflow Limitation, The St, George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992;145:1321-1327.
  • 17. Guyatt GH, Berman LB, Townsend M, et al. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987;42:773-778.
  • 18. Fletcher CM. Standardised questionnaire on respiratory symptoms: a statement prepared and approved by the MRC Committee on the Aetiology of Chronic Bronchitis (MRC breathlessness score). Br Med J. 1960;2:1665.
  • 19. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361-370.
  • 20. Papaliodis DN, Bonanni PG, Roberts TT, et al. Computer Assisted Cobb Angle Measurements: A novel algorithm. Int J Spine Surg. 2017;11:21.
  • 21. Conti G, Rocco M, Antonelli M, et al. Respiratory system mechanics in the early phase of acute respiratory failure due to severe kyphoscoliosis. Intensive Care Med. 1997;23:539-544.
  • 22. Fuschillo S, De Felice A, Martucci M, et al. Pulmonary rehabilitation improves exercise capacity in subjects with kyphoscoliosis and severe respiratory impairment. Respir Care. 2015;60:96-101.
  • 23. Jones DJ, Paul EA, Bell JH, et al. Ambulatory oxygen therapy in stable kyphoscoliosis. Eur Respir J. 1995;8:819-823.
  • 24. Rokach A, Romem A, Arish N, et al. The Effect of Pulmonary Rehabilitation on Non-chronic Obstructive Pulmonary Disease Patients. Isr Med Assoc J. 2019;21:326-329.
  • 25. Cejudo P, López-Márquez I, López-Campos JL, et al. Exercise Training in Patients With Chronic Respiratory Failure Due to Kyphoscoliosis: A Randomized Controlled Trial. Respir Care. 2014;59:375-382.
  • 26. Lisboa C, Moreno R, Fava M, et al. Inspiratory muscle function in patients with severe kyphoscoliosis. Am Rev Respir Dis. 1985;132:48-52.
  • 27. Swallow EB, Barreiro E, Gosker H, et al. Quadriceps muscle strength in scoliosis. Eur Respir J. 2009;34:1429-1435.
  • 28. Wind AE, Takken T, Helders PJM, et al. Is grip strength a predictor for total muscle strength in healthy children, adolescents, and young adults? Eur J Pediatr. 2010;169:281-287.
  • 29. López-Campos JL, Cejudo P, Ortega F, et al. Shuttle walking versus maximal cycle testing: clinical correlates in patients with kyphoscoliosis. Respir Physiol Neurobiol. 2008;160:334-340.
  • 30. Naji NA, Connor MC, Donnelly SC, et al. Effectiveness of pulmonary rehabilitation in restrictive lung disease. J Cardiopulm Rehabil. 2006;26:237- 243.
There are 30 citations in total.

Details

Primary Language English
Subjects Physical Medicine and Rehabilitation
Journal Section Systematic Reviews and Meta Analysis
Authors

Seher Satar 0000-0003-2896-6723

Pınar Ergün 0000-0001-8169-4689

Publication Date June 30, 2022
Published in Issue Year 2022 Volume: 75 Issue: 2

Cite

APA Satar, S., & Ergün, P. (2022). Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent? Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(2), 295-302. https://doi.org/10.4274/atfm.galenos.2022.54376
AMA 1.Satar S, Ergün P. Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent? Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(2):295-302. doi:10.4274/atfm.galenos.2022.54376
Chicago Satar, Seher, and Pınar Ergün. 2022. “Efficacy of Comprehensive Pulmonary Rehabilitation in Patients With Kyphoscoliosis; In Which Patients, the Gainings Are Prominent?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 (2): 295-302. https://doi.org/10.4274/atfm.galenos.2022.54376.
EndNote Satar S, Ergün P (June 1, 2022) Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent? Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 2 295–302.
IEEE [1]S. Satar and P. Ergün, “Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent?”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 2, pp. 295–302, June 2022, doi: 10.4274/atfm.galenos.2022.54376.
ISNAD Satar, Seher - Ergün, Pınar. “Efficacy of Comprehensive Pulmonary Rehabilitation in Patients With Kyphoscoliosis; In Which Patients, the Gainings Are Prominent?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/2 (June 1, 2022): 295-302. https://doi.org/10.4274/atfm.galenos.2022.54376.
JAMA 1.Satar S, Ergün P. Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent? Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:295–302.
MLA Satar, Seher, and Pınar Ergün. “Efficacy of Comprehensive Pulmonary Rehabilitation in Patients With Kyphoscoliosis; In Which Patients, the Gainings Are Prominent?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 2, June 2022, pp. 295-02, doi:10.4274/atfm.galenos.2022.54376.
Vancouver 1.Satar S, Ergün P. Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent? Ankara Üniversitesi Tıp Fakültesi Mecmuası [Internet]. 2022 June 1;75(2):295-302. Available from: https://izlik.org/JA26YW28HY