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B Yoo - One of the best experts on this subject based on the ideXlab platform.
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thu0267 a randomized controlled trial of the efficacy of Incentive Spirometer exercise on pulmonary functions of patients with ankylosing spondylitis stabilized by tumor necrosis factor inhibitor therapy
Annals of the Rheumatic Diseases, 2013Co-Authors: Bon San Koo, W J Seo, Y G Kim, C K Lee, B YooAbstract:Background The ASAS/EULAR guidelines recommend that patients with ankylosing spondylitis (AS) should be managed by a combination of pharmacological and non-pharmacological therapy. The non-pharmacological arm encompasses education, exercise, and physiotherapy. In particular, exercise seems to play an important role in the management of AS, particularly when performed in a supervised outpatient group setting, intensively with inpatients, spa-based exercise, or swimming exercise (1-2). However, some AS patients find that it is difficult to follow the recommendations because of lack of time, economic issues, and patient social status. An Incentive Spirometer is a device that is designed to achieve and sustain maximal inspiration. It is inexpensive and simple to use, patients do not require supervision once trained in its use, and there are no known side effects. Objectives We hypothesized that combining Incentive Spirometer exercise (ISE) with conventional exercise (CE) may improve the efficacy of a rehabilitation program, resulting in better functional capacity and pulmonary function. In the present study, the effects of combination treatment (ISE and CE) were compared to those of CE alone in patients whose AS had been stabilized by tumor necrosis factor (TNF) inhibitor therapy. Methods This was a 16-week randomized open label case-control single center study. Forty-six patients (44 men, two women) were randomized to the combination (ISE plus CE) group (n=23) or the CE group (n=23). The CE regimen of both groups consisted of 20 exercises performed for 30 minutes once a day. In addition to CE, patients in combination treatment group were instructed how to use the Incentive Spirometer and performed 30 minutes of CE and 30 minutes ISE once a day for 16 weeks. Patients were assessed before and at the end of treatment by measuring the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), chest expansion, finger to floor distance, pulmonary function parameters, and 6-min walk distance. Results Both groups improved significantly in terms of chest expansion (p Conclusions Combining ISE with a CE can provide positive results in patients whose AS has been clinically stabilized by TNF inhibitor therapy. References Braun J, van den Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011;70:896-904. Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev 2008:CD002822. Disclosure of Interest None Declared
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efficacy of Incentive Spirometer exercise on pulmonary functions of patients with ankylosing spondylitis stabilized by tumor necrosis factor inhibitor therapy
The Journal of Rheumatology, 2012Co-Authors: Hyun Mi Heo, Bon San Koo, Yonggil Kim, Changkeun Lee, B YooAbstract:Objective. To evaluate the effect of combining Incentive Spirometer exercise (ISE) with a conventional exercise (CE) on patients with ankylosing spondylitis (AS) stabilized by tumor necrosis factor (TNF) inhibitor therapy by comparing a combination group with a CE-alone group. Methods. Forty-six patients (44 men, 2 women) were randomized to the combination group (ISE plus CE; n = 23) or the CE group (n = 23). The CE regimen of both groups consisted of 20 exercises performed for 30 min once a day. The ISE was performed once a day for 30 min. The trial duration was 16 weeks. Patients were assessed before and at the end of treatment by measuring the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), chest expansion, finger to floor distance, pulmonary function measures, and 6-min walk distance. Results. Both groups improved significantly in terms of chest expansion (p Conclusion. Combining ISE with a CE can provide positive results in patients whose AS has been clinically stabilized by TNF inhibitor therapy.
Adam E M Eltorai - One of the best experts on this subject based on the ideXlab platform.
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effect of an Incentive Spirometer patient reminder after coronary artery bypass grafting a randomized clinical trial
JAMA Surgery, 2019Co-Authors: Adam E M Eltorai, Grayson L Baird, Terrance T Healey, Saurabh Agarwal, Corey E Ventetuolo, Thomas Martin, Jane Chen, Layla Kazemi, Catherine A KeableAbstract:Importance Incentive Spirometers (ISs) were developed to reduce atelectasis and are in widespread clinical use. However, without IS use adherence data, the effectiveness of IS cannot be determined. Objective To evaluate the effect of a use-tracking IS reminder on patient adherence and clinical outcomes following coronary artery bypass grafting (CABG) surgery. Design, Setting, and Participants This randomized clinical trial was conducted from June 5, 2017, to December 29, 2017, at a tertiary referral teaching hospital and included 212 patients who underwent CABG, of whom 160 participants were randomized (intent to treat), with 145 completing the study per protocol. Participants were stratified by surgical urgency (elective vs nonelective) and sex (men vs women). Interventions A use-tracking, IS add-on device (SpiroTimer) with an integrated use reminder bell recorded and timestamped participants’ inspiratory breaths. Patients were randomized by hourly reminder “bell on” (experimental group) or “bell off” (control group). Main Outcomes and Measures Incentive Spirometer use was recorded for the entire postoperative stay and compared between groups. Radiographic atelectasis severity (score, 0-10) was the primary clinical outcome. Secondary respiratory and nonrespiratory outcomes were also evaluated. Results A total of 145 per-protocol participants (112 men [77%]; mean age, 69 years [95% CI, 67-70]; 90 [62%] undergoing a nonelective procedure) were evaluated, with 74 (51.0%) in the bell off group and 71 (49.0%) in the bell on group. The baseline medical and motivation-to-recover characteristics of the 2 groups were similar. The mean number of daily inspiratory breaths was greater in bell on (35; 95% CI, 29-43 vs 17; 95% CI, 13-23; P P P = .48), the mean atelectasis severity scores for the final chest radiographs conducted before discharge were significantly lower for bell on than bell off group (1.5; 95% CI, 1.3-1.8 vs 1.8; 95% CI, 1.6-2.1; P = .04). Of those with early postoperative fevers, fever duration was shorter for bell on (3.2 hours; 95% CI, 2.3-4.6 vs 5.2 hours; 95% CI, 3.9-7.0; P = .04). Having the bell turned on reduced noninvasive positive pressure ventilation use rates (37.2%; 95% CI, 24.1%-52.5% vs 19.2%; 95% CI, 10.2%-33.0%; P = .03) for participants undergoing nonelective procedures. Bell on reduced the median postoperative length of stay (7 days; 95% CI, 6-9 vs 6 days; 95% CI, 6-7; P = .048) and the intensive care unit length of stay for patients undergoing nonelective procedures (4 days; 95% CI, 3-5 vs 3 days; 95% CI, 3-4; P = .02). At 6 months, the bell off mortality rate was higher than bell on (9% vs 0%, P = .048) for participants undergoing nonelective procedures. Conclusions and Relevance The Incentive Spirometer reminder improved patient adherence, atelectasis severity, early postoperative fever duration, noninvasive positive pressure ventilation use, ICU and length of stay, and 6-month mortality in certain patients. With the reminder, IS appears to be clinically effective when used appropriately. Trial Registration ClinicalTrials.gov identifier:NCT02952027
Guilherme Fregonezi - One of the best experts on this subject based on the ideXlab platform.
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acute effects of three pulmonary reexpansion modalities on thoracoabdominal motion of healthy subjects randomized crossover study
PLOS ONE, 2019Co-Authors: Rencio Florencio, Vanessa Resqueti, Andrea Aliverti, Antônio José Sarmento Da ,nóbrega, Marina Lyra Lima Cabral Fagundes, Ilsa Priscila Dos Santos Batista, Guilherme FregoneziAbstract:Background Chest physiotherapy can be an alternative to increase lung volumes through pulmonary expansion therapies, but there is still inconsistency in the literature in order to determine which device can promote a greater volume increase at the expense of a better ventilatory pattern. Therefore, the aim of this study was to evaluate and compare the chest wall kinematics of healthy subjects submitted to the use of three different devices for pulmonary reexpansion. Methods Chest wall compartmental and operational volumes, breathing pattern and thoracoabdominal asynchrony were evaluated in 12 healthy individuals through optoelectronic plethysmography during quiet breathing, pulmonary reexpansion and recovery. Three different devices (volume-oriented Incentive Spirometer–IS-v; positive expiratory pressure–PEP; and Incentive Spirometer volume and pressure oriented–IS-vp) were administered in a random order with at least 48h between the devices. Results A greater volume variation in the chest wall and its compartments was observed when the IS-vp was used in comparison with the other devices (p<0.05). Furthermore, the IS-vp mobilizes a greater amount of volume accompanied by greater synchronism between the compartments when compared to IS-v (p <0.05). Conclusion The IS-vp may be able to increase total and compartmental chest wall volumes, as well as improve synchrony among compartments when compared to IS-v and PEP devices, thus constituting an important tool for treating patients with restrictive ventilatory pattern.
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effects of positive expiratory pressure and volume oriented Incentive Spirometer on chest wall volumes in patients with stroke
European Respiratory Journal, 2014Co-Authors: Rencio Florencio, Lucien Peroni Gualdi, Illia Dantas Florentino, Rodrigo Rodrigues Melo De Lima, Elis Alves Cabral, Vanessa Resqueti, Andrea Aliverti, Guilherme FregoneziAbstract:Objective: to evaluate volume variations of chest wall (CW) and its compartments during the use of Positive Expiratory Pressure (PEP) and Volume-Oriented Incentive Spirometer (Vo-IS) in patients with stroke by Optoelectronic Plethysmography (OEP). Methods: 12 subjects with stroke diagnosis (54.5±9.7 years, BMI: 27.1±3.1, FVC%: 89.6±13, FEV1/FVC%:102.0±8.6, PImax%:76.3±27, PEmax%:89.4±24) were included in the study. On day 1 of the protocol anthropometric characteristics, respiratory muscles strength and lung function were collected. On day 2 and 3, OEP values were collected during the use of Vo-IS and 3 levels of PEP (10, 15 and 20 cmH2O). Results: RR was significantly higher during the use of PEP compared to Vo-IS (Mean: 11.8±4.7 vs. 5.5±2.3 min-1) (p<0.0001) while inspiratory (5.7±1.8 vs. 2±0.7), expiratory (6.3±2 vs. 4.1±1.9) and total respiratory cycle (12.2±3.3 vs. 6.1±2.3) time were significantly higher during Vo-IS compared to PEP (p<0.0001). Tidal volume (VT) was significantly increased during the use of Vo-IS compared to quite breathing for CW and its compartments (p<0.05) while the use of 15 and 20 cmH2O of PEP showed significantly higher values for VTCW only (p<0.05).VT was significantly higher in Vo-IS compared to PEP in all compartments (p<0.05). ![Figure][1] Conclusion: Vo-IS induced higher modifications on breathing pattern and CW volumes compared to different intensities of PEP. [1]: pending:yes
Catherine A Keable - One of the best experts on this subject based on the ideXlab platform.
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effect of an Incentive Spirometer patient reminder after coronary artery bypass grafting a randomized clinical trial
JAMA Surgery, 2019Co-Authors: Adam E M Eltorai, Grayson L Baird, Terrance T Healey, Saurabh Agarwal, Corey E Ventetuolo, Thomas Martin, Jane Chen, Layla Kazemi, Catherine A KeableAbstract:Importance Incentive Spirometers (ISs) were developed to reduce atelectasis and are in widespread clinical use. However, without IS use adherence data, the effectiveness of IS cannot be determined. Objective To evaluate the effect of a use-tracking IS reminder on patient adherence and clinical outcomes following coronary artery bypass grafting (CABG) surgery. Design, Setting, and Participants This randomized clinical trial was conducted from June 5, 2017, to December 29, 2017, at a tertiary referral teaching hospital and included 212 patients who underwent CABG, of whom 160 participants were randomized (intent to treat), with 145 completing the study per protocol. Participants were stratified by surgical urgency (elective vs nonelective) and sex (men vs women). Interventions A use-tracking, IS add-on device (SpiroTimer) with an integrated use reminder bell recorded and timestamped participants’ inspiratory breaths. Patients were randomized by hourly reminder “bell on” (experimental group) or “bell off” (control group). Main Outcomes and Measures Incentive Spirometer use was recorded for the entire postoperative stay and compared between groups. Radiographic atelectasis severity (score, 0-10) was the primary clinical outcome. Secondary respiratory and nonrespiratory outcomes were also evaluated. Results A total of 145 per-protocol participants (112 men [77%]; mean age, 69 years [95% CI, 67-70]; 90 [62%] undergoing a nonelective procedure) were evaluated, with 74 (51.0%) in the bell off group and 71 (49.0%) in the bell on group. The baseline medical and motivation-to-recover characteristics of the 2 groups were similar. The mean number of daily inspiratory breaths was greater in bell on (35; 95% CI, 29-43 vs 17; 95% CI, 13-23; P P P = .48), the mean atelectasis severity scores for the final chest radiographs conducted before discharge were significantly lower for bell on than bell off group (1.5; 95% CI, 1.3-1.8 vs 1.8; 95% CI, 1.6-2.1; P = .04). Of those with early postoperative fevers, fever duration was shorter for bell on (3.2 hours; 95% CI, 2.3-4.6 vs 5.2 hours; 95% CI, 3.9-7.0; P = .04). Having the bell turned on reduced noninvasive positive pressure ventilation use rates (37.2%; 95% CI, 24.1%-52.5% vs 19.2%; 95% CI, 10.2%-33.0%; P = .03) for participants undergoing nonelective procedures. Bell on reduced the median postoperative length of stay (7 days; 95% CI, 6-9 vs 6 days; 95% CI, 6-7; P = .048) and the intensive care unit length of stay for patients undergoing nonelective procedures (4 days; 95% CI, 3-5 vs 3 days; 95% CI, 3-4; P = .02). At 6 months, the bell off mortality rate was higher than bell on (9% vs 0%, P = .048) for participants undergoing nonelective procedures. Conclusions and Relevance The Incentive Spirometer reminder improved patient adherence, atelectasis severity, early postoperative fever duration, noninvasive positive pressure ventilation use, ICU and length of stay, and 6-month mortality in certain patients. With the reminder, IS appears to be clinically effective when used appropriately. Trial Registration ClinicalTrials.gov identifier:NCT02952027
Bon San Koo - One of the best experts on this subject based on the ideXlab platform.
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thu0267 a randomized controlled trial of the efficacy of Incentive Spirometer exercise on pulmonary functions of patients with ankylosing spondylitis stabilized by tumor necrosis factor inhibitor therapy
Annals of the Rheumatic Diseases, 2013Co-Authors: Bon San Koo, W J Seo, Y G Kim, C K Lee, B YooAbstract:Background The ASAS/EULAR guidelines recommend that patients with ankylosing spondylitis (AS) should be managed by a combination of pharmacological and non-pharmacological therapy. The non-pharmacological arm encompasses education, exercise, and physiotherapy. In particular, exercise seems to play an important role in the management of AS, particularly when performed in a supervised outpatient group setting, intensively with inpatients, spa-based exercise, or swimming exercise (1-2). However, some AS patients find that it is difficult to follow the recommendations because of lack of time, economic issues, and patient social status. An Incentive Spirometer is a device that is designed to achieve and sustain maximal inspiration. It is inexpensive and simple to use, patients do not require supervision once trained in its use, and there are no known side effects. Objectives We hypothesized that combining Incentive Spirometer exercise (ISE) with conventional exercise (CE) may improve the efficacy of a rehabilitation program, resulting in better functional capacity and pulmonary function. In the present study, the effects of combination treatment (ISE and CE) were compared to those of CE alone in patients whose AS had been stabilized by tumor necrosis factor (TNF) inhibitor therapy. Methods This was a 16-week randomized open label case-control single center study. Forty-six patients (44 men, two women) were randomized to the combination (ISE plus CE) group (n=23) or the CE group (n=23). The CE regimen of both groups consisted of 20 exercises performed for 30 minutes once a day. In addition to CE, patients in combination treatment group were instructed how to use the Incentive Spirometer and performed 30 minutes of CE and 30 minutes ISE once a day for 16 weeks. Patients were assessed before and at the end of treatment by measuring the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), chest expansion, finger to floor distance, pulmonary function parameters, and 6-min walk distance. Results Both groups improved significantly in terms of chest expansion (p Conclusions Combining ISE with a CE can provide positive results in patients whose AS has been clinically stabilized by TNF inhibitor therapy. References Braun J, van den Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011;70:896-904. Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev 2008:CD002822. Disclosure of Interest None Declared
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efficacy of Incentive Spirometer exercise on pulmonary functions of patients with ankylosing spondylitis stabilized by tumor necrosis factor inhibitor therapy
The Journal of Rheumatology, 2012Co-Authors: Hyun Mi Heo, Bon San Koo, Yonggil Kim, Changkeun Lee, B YooAbstract:Objective. To evaluate the effect of combining Incentive Spirometer exercise (ISE) with a conventional exercise (CE) on patients with ankylosing spondylitis (AS) stabilized by tumor necrosis factor (TNF) inhibitor therapy by comparing a combination group with a CE-alone group. Methods. Forty-six patients (44 men, 2 women) were randomized to the combination group (ISE plus CE; n = 23) or the CE group (n = 23). The CE regimen of both groups consisted of 20 exercises performed for 30 min once a day. The ISE was performed once a day for 30 min. The trial duration was 16 weeks. Patients were assessed before and at the end of treatment by measuring the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), chest expansion, finger to floor distance, pulmonary function measures, and 6-min walk distance. Results. Both groups improved significantly in terms of chest expansion (p Conclusion. Combining ISE with a CE can provide positive results in patients whose AS has been clinically stabilized by TNF inhibitor therapy.
