加拿大肺协会 - 加拿大呼吸健康专业人员;封德RECHERCHE魁北克 - 桑特（FRQS）

<ol>
	<li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global+Strategy+for+the+Diagnosis,+Management,+and+Prevention+of+Chronic+Obstructive+Pulmonary+Disease+[Internet].">Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease [Internet].</a> Global Initiative for Chronic Obstructive Lung Disease (GOLD). , (2013).</li><li>Celli, B. R., MacNee, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Standards+for+the+diagnosis+and+treatment+of+patients+with+COPD:+a+summary+of+the+ATS/ERS+position+paper).">Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper).</a> Eur. Respir. J. 23 (6), 932-946 (2004).</li><li>O'Donnell, D. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Canadian+Thoracic+Society+recommendations+for+management+of+chronic+obstructive+pulmonary+disease--2003.">Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease--2003.</a> Can. Respir. J. 10 Suppl A, 11 (2003).</li><li>Lacasse, Y., Maltais, F., Goldstein, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pulmonary+rehabilitation:+an+integral+part+of+the+long-term+management+of+COPD.">Pulmonary rehabilitation: an integral part of the long-term management of COPD.</a> Swiss Med, Wkly. 134 (41-42), 601-605 (2004).</li><li>Hui, K. P., Hewitt, A. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+simple+pulmonary+rehabilitation+program+improves+health+outcomes+and+reduces+hospital+utilization+in+patients+with+COPD.">A simple pulmonary rehabilitation program improves health outcomes and reduces hospital utilization in patients with COPD.</a> Chest. 124 (1), 94-97 (2003).</li><li>Lacasse, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pulmonary+rehabilitation+for+chronic+obstructive+pulmonary+disease.">Pulmonary rehabilitation for chronic obstructive pulmonary disease.</a> The Cochrane Database of Systematic Reviews. (4), (2001).</li><li>Guell, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+effects+of+outpatient+rehabilitation+of+COPD:+A+randomized+trial.">Long-term effects of outpatient rehabilitation of COPD: A randomized trial.</a> Chest. 117 (4), 976-983 (2000).</li><li>Hui, K. P., Hewitt, A. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+simple+pulmonary+rehabilitation+program+improves+health+outcomes+and+reduces+hospital+utilization+in+patients+with+COPD.">A simple pulmonary rehabilitation program improves health outcomes and reduces hospital utilization in patients with COPD.</a> Chest. 124 (1), 94-97 (2003).</li><li>Griffiths, T. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Results+at+1+year+of+outpatient+multidisciplinary+pulmonary+rehabilitation:+a+randomised+controlled+trial.">Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial.</a> Lancet. 355 (9201), 362-368 (2000).</li><li>Young, P., Dewse, M., Fergusson, W., Kolbe, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improvements+in+outcomes+for+chronic+obstructive+pulmonary+disease+(COPD)+attributable+to+a+hospital-based+respiratory+rehabilitation+programme.">Improvements in outcomes for chronic obstructive pulmonary disease (COPD) attributable to a hospital-based respiratory rehabilitation programme.</a> Aust. NZ J. Med. 29 (1), 59-65 (1999).</li><li>Stewart, D. G., Drake, D. F., Robertson, C., Marwitz, J. H., Kreutzer, J. S., Cifu, D. X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Benefits+of+an+inpatient+pulmonary+rehabilitation+program:+a+prospective+analysis.">Benefits of an inpatient pulmonary rehabilitation program: a prospective analysis.</a> Arch. Phys. Med .Rehabil. 82 (3), 347-352 (2001).</li><li>Bowen, J. B., Thrall, R. S., ZuWallack, R. L., Votto, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+benefits+of+short-stay+inpatient+pulmonary+rehabilitation+in+severe+chronic+obstructive+pulmonary+disease.">Long-term benefits of short-stay inpatient pulmonary rehabilitation in severe chronic obstructive pulmonary disease.</a> Monaldi Arch. Chest Dis. 54 (2), 189-192 (1999).</li><li>Foglio, K., Bianchi, L., Ambrosino, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+it+really+useful+to+repeat+outpatient+pulmonaryrehabilitation+programs+in+patients+with+chronic+airway+obstruction?+A+2-year+controlled+study.">Is it really useful to repeat outpatient pulmonaryrehabilitation programs in patients with chronic airway obstruction? A 2-year controlled study.</a> Chest. 119 (6), 1696-1704 (2001).</li><li>George, J., Kong, D. C. M., Stewart, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adherence+to+disease+management+programs+in+patients+with+COPD.">Adherence to disease management programs in patients with COPD.</a> International Journal of COPD. 2 (3), 253-262 (2007).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adherence+to+long-term+therapies:+evidence+for+action.">Adherence to long-term therapies: evidence for action.</a> Annex. 1, (2003).</li><li>Hogg, L., Garrod, R., Thornton, H., McDonnell, L., Bellas, H. &. a. m. p. ;., White, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effectiveness,+attendance,+and+completion+of+an+integrated,+system-wide+pulmonary+rehabilitation+service+for+COPD:+prospective+observational+study.">Effectiveness, attendance, and completion of an integrated, system-wide pulmonary rehabilitation service for COPD: prospective observational study.</a> COPD. 9 (5), 546-554 (2012).</li><li>Singh, S. J., Smith, D. L., Hyland, M. E., Morgan, M. D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+short+outpatient+pulmonary+rehabilitation+programme:+immediate+and+longer+term+effects+on+exercise+performance+and+quality+of+life.">A short outpatient pulmonary rehabilitation programme: immediate and longer term effects on exercise performance and quality of life.</a> Respir. Med. 92, 1146-1154 (1998).</li><li>Young, P., Dewse, M., Fergusson, W., Kolbe, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Respiratory+rehabilitation+in+chronic+obstructive+pulmonary+disease:+predictors+of+nonadherence.">Respiratory rehabilitation in chronic obstructive pulmonary disease: predictors of nonadherence.</a> Eur. Respir. J. 13, 855-859 (1999).</li><li>Brooks, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+pulmonary+rehabilitation+programs+in+Canada+in.">Characterization of pulmonary rehabilitation programs in Canada in.</a> Can. Respir. J. 14 (2), 87-92 (2005).</li><li>Fischer, M. J., Scharloo, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Drop-out+and+attendance+in+pulmonary+rehabilitation:+the+role+of+clinical+and+psychosocial+variables.">Drop-out and attendance in pulmonary rehabilitation: the role of clinical and psychosocial variables.</a> Respir. Med. 103 (10), 1564-1571 .</li><li>Sabit, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Predictors+of+poor+attendance+at+an+outpatient+pulmonary+rehabilitation+programme.">Predictors of poor attendance at an outpatient pulmonary rehabilitation programme.</a> Respir. Med. 102 (6), 819-824 .</li></ol>

作者宣称，他们有没有竞争的财务权益。

连续数据跟踪技术使锻炼坚持的一个非常精确的测量。这个程序可以通过与目标功率，水平，速度，或Met水平目标取代心脏速率范围内很容易地适应坚持的其他定义。在本例中，热身和冷却阶段被淘汰隔离，因为我们的具体研究对象的运动阶段。应该热身和冷却阶段会感兴趣的其他研究人员，步2.3（"消除nontraining阶段"）可以从协议被淘汰。此外，该硬件和软件也可用来测量粘附到其它模式的训练，诸如跑步机，椭圆形，步进，并且臂测力计。 按照上述协议时，一些简单的步骤是至关重​​要的。首先，CardioMemory软件必须在运动器材（ 例如 ，功率自行车）前开始锻炼数据是TRAC糟透了和随后记录。应数据在该初始步骤被丢失，数据提取协议将需要作相应调整。其次，干扰源必须被最小化，以降低串扰和/或数据丢失的风险。的心脏速率监视器的设备和软件进行无线通讯。因此，如果使用目标心脏率计算粘附干扰尤为不利。最后，当务之急是要选择有允许对大量数据的能力，数据库统计软件。例如，在与10名学员完成36节在每个40分钟的研究，864,000行的数据点将会产生。 Excel 2007和更高版本必须包含1,048,576行的工作表23的容量，而24的SAS和SPSS 25没有限制的行数。取决于预期的一个给定的学习数据点的总数，软件需要被相应地选择。 </p&gt; 尽管这种技术的显着优点，有两个主要的限制存在。第一是数据丢失，这可能会导致从设备和/或软件故障。如上面提到的，数据损失可能是由于与无线设备（ 即移动电话或Wi-Fi）的电气干扰，并且更具体地与心脏率的无线数据传输的干扰。然而，有时，数据丢失也可以是由于无法识别的原因。第二个限制是，该软件不提供标记或系统分裂运动方案，以区分/识别不同阶段的选择。如果这个选项是可用的，所关注的运动阶段的提取可以直接在软件中执行，这将限制在遵守协议的计算步骤。还有，将标记的办法是不切实际的坚持间隔或间歇训练方案的研究，这将允许不同阶段（ 如 。低与高强度）的分化。 对于未来的前景，利用连续的数据跟踪技术来精确地量化坚持将使研究人员能够观察运动反应的模式，以不同的干预措施，确定坚持的决定因素和表征，差的遵从。最终，更好地理解运动坚持将允许运动康复计划的优化。

肺康复（PR）的结合运动训练，患者教育和心理支持，并得到广泛公认的肺病1-5的管理基石。公关的目的是减轻症状，优化功能状态，提高生活健康质量，降低医疗费用4,5。在一项荟萃分析的随机31在慢性阻塞性肺疾病（COPD）对照试验，公关被证明显著提高运动能力，减轻呼吸困难和疲劳，改善情绪的功能，并加强对他们的状况6控制病人的意识。此外，证据记录其在减少住院8-13花费呼吸加重7天效果。运动训练被认为是成功的关键在于公关，因为它负责许多与此干预3-5带来的好处。然而，有几个的重大课题患者是秉承建议运动量或水平。不依从推荐的治疗可能导致治疗干预的失败，以及低效利用卫生资源14。 据世界卫生组织，术语&#39;&#39;&#39;&#39;坚持是指在何种程度上与由专业医务人员15给出建议，一个人的行为相吻合。迄今为止，坚持康复锻炼的设置培训已基本评定为参与任率（ 即 ，登记程序），完成率（ 即整理程序），或出席率（ 即行使号会议出席）16-18。目前，还没有"金标准"的存在，用于测量坚持15和当前方法不允许进行非常精确。此外，取决于所选择的METHOD，坚持公关率已经显示很大的变化16-19。例如，霍格等人在COPD患者16测量遵守那些谁完成了程序的简称，发现约40％的低依从性之间的比率。然而，已经使用的出席率其他公关的研究表明，平均而言，90％的依从10,20,21。在同质化计算坚持的缺乏使得它很难进行比较研究的结果。另一个值得关注的是缺乏精度与现有的计算方法;参加到运动训练并不保证遵守规定的强度。在信息这种差距导致我们研究如何坚持能以更精确的方式来计算。 在健身器材技术的最新进展已经允许连续的数据跟踪，它可以被用来监视遵守规定的有氧训练强度时individu在公关方面人锻炼。更具体地讲，数据跟踪硬件和软件许可证的持续时间的第二逐秒记录，速度级别，瓦数，速度，心脏速率，距离，卡路里消耗，VO 2，METS和热量，并提供所有变量的平均值与除了 ​​水平和VO 2。该技术的主要优点是可以连续录制的具体措施，允许坚持的精确计算，以运动处方与以前报道的一般出席或完成率的能力。这个过程可以是价值的任何研究探讨的一个或几个有氧运动训练方案的影响。使用这种技术，患者坚持规定的强度可以通过在过程中每个环节的训练阶段指定的瓦数，水平，速度，或心脏速率所花费的时间百分比来评估。对于我们的调查，坚持锻炼培训协议已被定义为百分比时间指定的目标心脏率范围之内度过的。由于在给定的亚极量负荷心脏率响应心肺适能的增加减少，这种方法可确保患者保持在相同的相对（而不是绝对）的训练强度在整个程序。本协议详细描述了如何连续数据跟踪技术可用于精确测量遵守规定目标心脏率范围。

<table border="0" cellpadding="0" cellspacing="0" width="892">
<colgroup>
<col />
<col />
<col />
<col />
</colgroup>
<tbody>
<tr height="21">
<td height="21" style="height:21px;width:195px;">Bike Excite Med 700</td>
<td style="width:239px;">Technogym - www.technogym.com</td>
<td style="width:164px;"> </td>
<td style="width:295px;">SCIFIT (http://scifit.com/)</td>
</tr>
<tr height="21">
<td height="21" style="height:21px;">CardioMemory software </td>
<td style="width:239px;">Technogym - www.technogym.com</td>
<td style="width:164px;">Version 1.0</td>
<td style="width:295px;">SCIFIT (http://scifit.com/)</td>
</tr>
<tr height="21">
<td height="21" style="height:21px;">Polar heart rate monitor</td>
<td style="width:239px;">Polar - www.polarca.com</td>
<td>T31 coded Transmitter</td>
<td style="width:295px;"> </td>
</tr>
<tr height="21">
<td height="21" style="height:21px;width:195px;">SPSS Statistical Software</td>
<td style="width:239px;">SPSS Inc. - www.spss.com/</td>
<td style="width:164px;">Version 16.0</td>
<td style="width:295px;">SAS/STAT software (http://www.sas.com/)</td>
</tr>
<tr height="21">
<td height="21" style="height:21px;width:195px;"> </td>
<td style="width:239px;"> </td>
<td style="width:164px;"> </td>
<td style="width:295px;"> </td>
</tr>
</tbody>
</table>

using continuous data tracking technology to study exercise adherence in pulmonary rehabilitation

肺康复（PR）是呼吸系统疾病的管理的一个重要组成部分。公关的有效性依赖于坚持运动锻炼的建议。因而坚持锻炼的研究是对的公关计划优化的关键一步。迄今为止，大多是间接的措施，如参与，完成和出席率，已被用来确定坚持公关。本议定书的目的是描述如何连续数据跟踪技术可用于测量遵守规定的有氧训练强度在第二逐秒为计算单位。 在我们的调查，坚持已被定义为一个指定的目标心脏率范围内所花的时间百分比。因此，使用硬件和软件的结合，心脏速率循环过程中测量，跟踪和记录的第二个逐秒的每个参与者，每个练习会话。使用统计软件，T他数据随后被提取和分析。相同的协议可以被用于确定遵守运动强度的其它措施，如时间在指定的功率，电平，或者在功率自行车速度略去。此外，该硬件和软件也可用来测量粘附到其它模式的训练，诸如跑步机，椭圆形，步进，并且臂测力计。本协议，因此，具有广阔的应用直接测量坚持有氧运动。

<html>当正确执行的协议，是各科为每个会话（ 图13）获得的贴壁率，每个科目的所有会话（ 图14），并为每个会话的所有科目组合。来完成上述协议为1主体的单个会话所需的时间的估计值是约5分钟。结果坚持的范围可以从0-100％。利用这些信息，更多的分析，可以进行判断科目（ 即性别差异，疾病的严重程度等 ），以确定随时间的变化，并揭示模式在坚持差异。此外，坚持群体之间的比较可以进行，例如，不同的运动训练计划可以比拟的。最后，通过进一步调查，不依从的原因可以发现在公关在特定的时间点。 <html> "&gt; <img alt="图1" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig1.jpg" width="600px" /> 图1。心率发射器的位置 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig1highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图2" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig2.jpg" width="600px" /> 图2:采用样本数据跟踪软件收集的数据 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig2highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图3" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig3.jpg" width="600px" /> 图3。样本数据跟踪软件输出 。jove.com/files/ftp_upload/50643/50643fig3highres.jpg"目标="_blank"&gt;点击这里查看大图。 <img alt="图4" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig4.jpg" width="600px" /> 图4。示例数据库说明统计软件数据库的样本 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig4highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图5" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig5.jpg" width="600px" /> 图5。示例数据库说明消除预热阶段 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig5highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图6" fo:content-width="5英寸"SRC ="/ files/ftp_upload/50643/50643fig6.jpg"宽度="600px的"/&gt; 图6。示例数据库说明消除冷却阶段 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig6highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图7" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig7.jpg" width="600px" /> 图7。示例说明数据库会话数增加了一个列 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig7highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图8" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig8.jpg" width="600px" /> 图8:示例数据库出了用于单participan合并会话<html>万吨。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig8highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图9" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig9.jpg" width="600px" /> 图9。示例数据库说明用于对象的识别号码添加一列 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig9highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图10" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig10.jpg" width="600px" /> 图10。示例数据库的说明心脏目标利率加一列 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig10highres.jpg" target="_blank">点击这里查看大图</a> 。 e_content"FO:保持together.within页="总是"&gt; <img alt="图11" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig11.jpg" width="600px" /> 图11。示例数据库说明合并后的参与者的文件 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig11highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图12" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig12.jpg" width="600px" /> 图12。示例数据库的说明心脏重新编码率的变量 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig12highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图13" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig13.jpg" width="600px" /> FIGURE 13。 示例数据库说明 （水平红线强调了同一主题的会议之间在坚持的变化） 坚持随着时间的目标心脏率范围内为每个会话度过每个科目的百分比 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig13highres.jpg" target="_blank">点击这里查看大图</a> 。 <img alt="图14" fo:content-width="5in" src="/files/ftp_upload/50643/50643fig14.jpg" width="600px" /> 图14。示例数据库说明坚持的时间目标心脏率范围内的所有会话 （水平红线突出主体之间的差额） 花费为每个主题的百分比 。 <a href="https://www.jove.com/files/ftp_upload/50643/50643fig14highres.jpg" target="_blank">点击这里查看大图</a> 。

Watch this Scientific Journal Video about Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation at JoVE.com

Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation

肺康复治疗是目前公认的呼吸系统疾病的管理。一个关键组成部分，以成功的肺康复是坚持推荐运动训练。本议定书的目的是描述如何连续数据跟踪技术可用于精确测量遵守规定的有氧训练强度。

使用连续数据跟踪技术在肺康复研究锻炼坚持性

Pulmonary rehabilitation (PR) is an important component in the management of respiratory diseases. The effectiveness of PR is dependent upon adherence to ...

using-continuous-data-tracking-technology-to-study-exercise-adherence

Research

JoVE Journal

Medicine

13.4K 次观看.  Concordia University. 肺康复治疗是目前公认的呼吸系统疾病的管理。一个关键组成部分，以成功的肺康复是坚持推荐运动训练。本议定书的目的是描述如何连续数据跟踪技术可用于精确测量遵守规定的有氧训练强度。 

视频: Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation

Manual Muscle Testing:  A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, and persistent nerve and muscle impairments after hospital discharge.1-6 Using an explicit protocol with a structured approach to training and quality assurance of research staff, manual muscle testing (MMT) is a highly reliable method for assessing strength, using a standardized clinical examination, for patients following ARDS, and can be completed with mechanically ventilated patients who can tolerate sitting upright in bed and are able to follow two-step commands. 7, 8 
This video demonstrates a protocol for MMT, which has been taught to &ge;43 research staff who have performed &gt;800 assessments on &gt;280 ARDS survivors. Modifications for the bedridden patient are included. Each muscle is tested with specific techniques for positioning, stabilization, resistance, and palpation for each score of the 6-point ordinal Medical Research Council scale.7,9-11 Three upper and three lower extremity muscles are graded in this protocol: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. These muscles were chosen based on the standard approach for evaluating patients for ICU-acquired weakness used in prior publications. 1,2.

Survivors of acute respiratory distress syndrome (ARDS) and critical illness frequently develop long-lasting muscle weakness. Manual muscle testing (MMT) is a standardized clinical examination commonly used to measure strength of peripheral skeletal muscle groups. This video demonstrates MMT using the 6-point Medical Research Council scale.

危重病人中的应用手册肌力测试:下肢肌力测量方法

Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, ...

科研

医学

Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the mid-thoracic level can lead to a potentially life-threatening hypertensive condition called autonomic dysreflexia (AD) that is often triggered by noxious or non-noxious somatic or visceral stimuli below the level of injury. One of the most common triggers of AD is the distension of pelvic viscera, such as during bladder and bowel distension or evacuation. This protocol presents a novel pattern recognition algorithm developed for a JAVA platform software to study the fluctuations of cardiovascular parameters as well as the number, severity and duration of spontaneously occurring AD events. The software is able to apply a pattern recognition algorithm on hemodynamic data such as systolic blood pressure (SBP) and heart rate (HR) extracted from telemetry recordings of conscious and unrestrained animals before and after thoracic (T3) complete transection. With this software, hemodynamic parameters and episodes of AD are able to be detected and analyzed with minimal experimenter bias.

The catheter of a telemetry device is implanted into the abdominal aorta in order to continuously collect beat-by-beat hemodynamic data from animals pre and post-high thoracic spinal cord transection. A novel JAVA software was employed to analyze hemodynamic parameters as well as frequency and intensity of spontaneous episodes of autonomic dysreflexia.

一个算法的开发与高位脊髓损伤使用遥测装置进行自主神经异常反射的动物的综合研究

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the ...

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure. At the same time, the recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) during exercise may contribute to gas exchange impairment and/or prevent large increases in pulmonary artery pressure.
We describe two techniques to evaluate pulmonary diffusion and circulation at rest and during exercise. The first technique uses multiple-fraction of inspired oxygen (FIO2) DLCO breath holds to determine Vc and Dm at rest and during exercise. Additionally, echocardiography with intravenous agitated saline contrast is used to assess IPAVAs recruitment.
Representative data showed that the DLCO, Vc, and Dm increased with exercise intensity. Echocardiographic data showed no IPAVA recruitment at rest, while contrast bubbles were seen in the left ventricle with exercise, suggesting exercise-induced IPAVA recruitment.
The evaluation of pulmonary capillary blood volume, membrane diffusing capacity, and IPAVA recruitment using echocardiographic methods is useful to characterize the ability of the lung vasculature to adapt to the stress of exercise in health as well as in diseased groups, such as those with pulmonary arterial hypertension and chronic obstructive pulmonary disease.

To assess the pulmonary diffusion and vasculature responses to exercise, we describe the multiple-inspired oxygen diffusion capacity technique to determine capillary blood volume and membrane diffusing capacity, as well as agitated saline contrast echocardiography to assess the recruitment of intrapulmonary arteriovenous anastomoses.

肺毛细血管血量，膜弥散能力，及肺内动静脉吻合的评估期间行使

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased ...

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure

Cerebral hypo-oxygenation during rest or exercise negatively impacts the exercise capacity of patients with heart failure with reduced ejection fraction (HF). However, in clinical cardiopulmonary exercise testing (CPET), cerebral hemodynamics is not assessed. NIRS is used to measure cerebral tissue oxygen saturation (SctO2) in the frontal lobe. This method is reliable and valid and has been utilized in several studies. SctO2 is lower during both rest and peak exercise in patients with HF than in healthy controls (66.3 &#177; 13.3% and 63.4 &#177; 13.8% vs. 73.1 &#177; 2.8% and 72 &#177; 3.2%). SctO2 at rest is significantly linearly correlated with peak VO2 (r = 0.602), oxygen uptake efficiency slope (r = 0.501), and brain natriuretic peptide (r = -0.492), all of which are recognized prognostic and disease severity markers, indicating its potential prognostic value. SctO2 is determined mainly by end-tidal CO2 pressure, mean arterial pressure, and hemoglobin in the HF population. This article demonstrates a protocol that integrates SctO2 using NIRS into incremental CPET on a calibrated bicycle ergometer.

This protocol integrated near-infrared spectroscopy into conventional cardiopulmonary exercise testing to identify the involvement of the cerebral hemodynamic response in exercise intolerance in patients with heart failure.

心力衰竭患者心肺运动测试中脑组织饱和监测的集成

Cerebral hypo-oxygenation during rest or exercise negatively impacts the exercise capacity of patients with heart failure with reduced ejection fraction ...

Providing Visual Biofeedback Using Brightness Mode Ultrasound During a Golf Swing

Using ultrasound biofeedback in conjunction with verbal cueing can increase muscle thickness more than verbal cueing alone and may augment traditional rehabilitation techniques in an athletic, physically active population. Brightness mode (B-mode) ultrasound can be applied using frame-by-frame analysis synchronized with video to understand muscle thickness changes during these dynamic tasks. Visual biofeedback with ultrasound has been established in static positions for the muscles of the lateral abdominal wall. However, by securing the transducer to the abdomen using an elastic belt and foam block, biofeedback can be applied during more specific tasks prevalent in lifetime sports, such as golf. To analyze muscle activity during a golf swing, muscle thickness changes can be compared. The thickness must increase throughout the task, indicating that the muscle is more active. This methodology allows clinicians to immediately replay ultrasound videos for patients as a visual tool to instruct proper activity of the muscles of interest. For example, ultrasound can be used to target the external and internal obliques, which play an important role in swinging a golf club or any other rotational sport or activity. This methodology aims to increase oblique muscle thickness during the golf swing. Additionally, the timing of muscle contraction can be targeted by instructing the patient to contract the abdominal muscles at specific time points, such as the beginning of the downswing, with the goal of improving muscle firing patterns during tasks.

Brightness mode ultrasound can be used to provide visual biofeedback of the muscles of the lateral abdominal wall during a golf swing. Post-swing visual and verbal instruction can increase the muscle activation and timing of the external and internal obliques.

在高尔夫挥杆期间使用亮度模式超声波提供视觉生物反馈

Using ultrasound biofeedback in conjunction with verbal cueing can increase muscle thickness more than verbal cueing alone and may augment traditional ...

Muscle Function Obtained with Motion Mode Ultrasound and Surface Electromyography during Core Endurance Exercise

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured between fascial borders at a given time point during an exercise. This selected time point produces a one-dimensional image resulting in real-time, live observation of anatomy. Ultrasound used during functional movement can be referred to as dynamic ultrasound; this is feasible and reliable with the use of a linear transducer, elastic belt, and foam block to secure consistent transducer placement. The lateral abdominal wall is commonly investigated using ultrasound due to the overlapping nature of the muscles. Surface electromyography (sEMG) can complement M-mode ultrasound imaging because it measures the electrical representation of muscle activation. There is minimal evidence using M-mode ultrasound and sEMG simultaneously during core exercise. Exercises that challenge the core musculature involve both isometric holds (e.g., side plank), as well as oscillatory extremity movements (e.g., dead bug). In this study, both instruments will be used simultaneously to measure core muscle function during exercise. Ultrasound measurements will be obtained using a linear transducer and ultrasound unit, and sEMG measurements will be acquired from a wireless sEMG system. To make comparisons between participants and exercises, normalization methods using static, exercise starting positions for both instruments will be used. An activation ratio will be used for ultrasound and calculated by dividing the contracted thickness (thickness during a time point of exercise) by the rested (starting position) thickness. Muscle thickness will be measured in centimeters from the superior inferior fascial border to inferior superior fascial border. These methods aim to offer an innovative and practical measurement of muscle function with M-mode ultrasound and sEMG during core endurance exercises.

This protocol uses motion mode ultrasound and surface electromyography simultaneously to measure muscle function of the core. Muscle thickness and activation of the local stabilizers (e.g., transverse abdominis, internal oblique) and global movers (e.g., external oblique) is achievable during specific time points of the side plank and dead bug exercises.

核心耐力运动期间通过运动模式超声和表面肌电图获得的肌肉功能

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured ...

通过基于虚拟现实的职业培训加强中风康复

Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System

Stroke rehabilitation often requires frequent and intensive therapy to improve functional recovery. Virtual reality (VR) technology has shown the potential to meet these demands by providing engaging and motivating therapy options. The digital occupational training system is a VR application that utilizes cutting-edge technologies, including multi-touch screens, virtual reality, and human-computer interaction, to offer diverse training techniques for advanced cognitive capacity and hand-eye coordination abilities. The objective of this study was to assess the effectiveness of this program in enhancing cognitive function and upper extremity rehabilitation in stroke patients. The training and assessment consist of five cognitive modules covering perception, attention, memory, logical reasoning, and calculation, along with hand-eye coordination training. This research indicates that after eight weeks of training, the digital occupational training system can significantly improve cognitive function, daily living skills, attention, and self-care abilities in stroke patients. This software can be employed as a time-saving and clinically effective rehabilitation aid to complement traditional one-on-one occupational therapy sessions. In summary, the digital occupational training system shows promise and offers potential financial benefits as a tool to support the functional recovery of stroke patients.

作者聚焦:使用数字职业培训系统实现中风患者的康复

The current protocol outlines how the VR-based digital occupational training system enhances the rehabilitation of patients with cognitive impairment and upper limb dysfunction following a stroke.

使用数字职业培训系统的中风后认知功能和上肢康复训练

Stroke rehabilitation often requires frequent and intensive therapy to improve functional recovery. Virtual reality (VR) technology has shown the ...

评估运动期间肺泡毛细血管储备

Dual Test Gas Pulmonary Diffusing Capacity Measurement During Exercise in Humans Using the Single-Breath Method

The combined single-breath measurement of the diffusing capacity of carbon monoxide (DL,CO) and nitric oxide (DL,NO) is a useful technique to measure pulmonary alveolar-capillary reserve in both healthy and patient populations. The measurement provides an estimate of the participant&#39;s ability to recruit and distend pulmonary capillaries. The method has recently been reported to exhibit a high test-retest reliability in healthy volunteers during exercise of light to moderate intensity. Of note, this technique permits up to 12 repeated maneuvers and only requires a single breath with a relatively short breath-hold time of 5 s. Representative data are provided showing the gradual changes in DL,NO and DL,CO from rest to exercise at increasing intensities&#160;of up to 60% of maximal workload. The measurement of diffusing capacity and evaluation of alveolar-capillary reserve is a useful tool to evaluate the lung&#39;s ability to respond to exercise both in the healthy population as well as in patient populations such as those with chronic lung disease.

作者聚焦:将肺泡毛细血管储备测量整合到运动适应和治疗策略中

This protocol presents a method to assess pulmonary alveolar-capillary reserve measured by combined single-breath measurement of the diffusing capacity to carbon monoxide (DL,CO) and nitric oxide (DL,NO) during exercise. Assumptions and recommendations for using the technique during exercise form the foundation of this article.

使用单次呼吸法测量人体运动期间的双重测试气体肺弥散能力

The combined single-breath measurement of the diffusing capacity of carbon monoxide (DL,CO) and nitric oxide (DL,NO) is a useful technique to measure ...