| Title |
Personalized pulmonary rehabilitation and occupational therapy based on cardiopulmonary exercise testing for patients with advanced chronic obstructive pulmonary disease
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, September 2015
|
| DOI | 10.2147/copd.s86455 |
| Pubmed ID | |
| Authors |
Ryoji Maekura, Toru Hiraga, Keisuke Miki, Seigo Kitada, Mari Miki, Kenji Yoshimura, Hiroshi Yamamoto, Toshiko Kawabe, Masahide Mori |
| Abstract |
Personalized pulmonary rehabilitation including occupational therapy improves the prognosis of patients with advanced COPD. We previously reported that patients with chronic obstructive pulmonary disease (COPD) exhibit three exercise-induced life-threatening conditions: hypoxemia, sympathetic overactivity, and respiratory acidosis. We aimed to verify whether mortality in patients with advanced COPD could be reduced by a personalized pulmonary rehabilitation (PPR) program in hospital, which determines individual safe ranges and includes occupational therapy (PPR-OT), to prevent desaturation and sympathetic nerve activation during daily activities. The novel PPR-OT program was evaluated in a retrospective study of patients with COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Grade D) who underwent cardiopulmonary exercise testing (CPET) between April 1990 and December 1999. They received regular treatment without the proposed therapy (control group: n=61; male-to-female ratio [M:F] =57:4; mean age: 68.5±6.7 years) or with the proposed therapy (PPR-OT group: n=46; M:F =44:2; mean age: 68.7±7.1 years). A prospective observational study included patients with COPD receiving home oxygen therapy (HOT) between April 1995 and March 2007 to compare the survival rates of the control group (n=47; M:F ratio =34:13; mean age: 71.3±10.0 years) and the PPR-OT group (n=85; M:F =78:7; mean age: 70.7±6.1 years) who completed the proposed therapy. Survival after CPET or HOT was analyzed using Cox proportional-hazards regression and Kaplan-Meier analyses. In both studies, the program significantly improved all-cause mortality (retrospective study: risk ratio =0.389 [range: 0.172-0.800]; P=0.0094; log-rank test, P=0.0094; observational study: risk ratio =0.515 [range: 0.296-0.933]; P=0.0291; log-rank test, P=0.0232]. At 5 years and 7 years, all-cause mortality was extremely low in patients in the PPR-OT group receiving HOT (18.8% and 28.2%, respectively), compared to that in the control group (34.0% and 44.7%, respectively). Survival of patients with life-threatening pathophysiological conditions also greatly improved. The PPR-OT program improved the survival of patients with advanced COPD probably because it modified life-threatening conditions. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 22% |
| United States | 1 | 11% |
| Korea, Democratic People's Republic of | 1 | 11% |
| Unknown | 5 | 56% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 67% |
| Practitioners (doctors, other healthcare professionals) | 3 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 105 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 105 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 22 | 21% |
| Student > Master | 19 | 18% |
| Student > Ph. D. Student | 10 | 10% |
| Researcher | 8 | 8% |
| Student > Doctoral Student | 5 | 5% |
| Other | 13 | 12% |
| Unknown | 28 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 25 | 24% |
| Medicine and Dentistry | 25 | 24% |
| Neuroscience | 4 | 4% |
| Agricultural and Biological Sciences | 3 | 3% |
| Arts and Humanities | 3 | 3% |
| Other | 10 | 10% |
| Unknown | 35 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2019.
All research outputs
#6,238,302
of 25,373,627 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#685
of 2,577 outputs
Outputs of similar age
#66,834
of 276,788 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#25
of 85 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. Compared to these this one has done well and is in the 75th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,577 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one has gotten more attention than average, scoring higher than 73% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 276,788 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 75% of its contemporaries.
We're also able to compare this research output to 85 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.