Severe Symptoms of COPD-Free-Samples for Students-Myassignment

Question: Do research on COPD and the effects of a Clinical 12 week exercise Intervention. Answer: Abstract: The number of people with moderate to severe COPD has been rising and the morbidity associated with the disease such as frequent asthma attacks and low lung function significantly affects the quality of life of affected people. The most severe symptoms of COPD is progressive shortness of breath resulting in deterioration in quality of life. To reduce the cost attributable to COPD care and management of symptoms of patient, the main purpose of this research was to investigate about the effects of a 12 week exercise intervention on anxiety and quality of life of patients with moderate to severe COPD. The main research hypothesis was that completion of 12 week exercise regimen will reduce perceived anxiety in patients with COPD. The study was done with two groups of participants selected from Manawatu region in New Zealand- first group had participants with moderate COPD and other group has patients with severe COPD with 30-50% predicted FEV1. (Forced expiration volume). All participant s were provided a 12 week exercise programme by U-kinetics exercise and wellness clinic. The statistical analysis of the data revealed positive changes in HADs scores, but moderate change on FEV results. Moderate group showed strong improvement in anxiety score and delayed effect was seen in severe group. Another important finding was that physical perception of self also influenced anxiety level of participants. Hence, the data differed based on severity of symptoms. It can be concluded that exercise interventions are beneficial for COPD patients, however there is a need to consider other strategies or longer duration of exercise programme to improve anxiety symptoms in COPD patients with severity of symptoms. Discussion: Patients with COPD having three or more comorbidities are frequently hospitalized and die prematurely compared to other patients. Among all the comorbidities, anxiety and depression has a major impact on burden of COPD, quality of life and adherence to treatment (Yohannes Alexopoulos 2014). As anxiety disorders are disabling and decrease self-esteem in patients, the importance of physical exercise in improving symptoms in severe to moderate COPD patients has been considered in this study. The aim of the research was to provide 12 week exercise intervention to reduce anxiety and depression in participants. The main exercise given to participants with severe and moderate COPD symptoms included combination of aerobic and resistance exercise provided for 50-60 minutes duration two to three days per week. The selection of aerobic exercise for COPD patients is an effective intervention for this research because evidence has proved that heart rate variability issues is major issue in COPD patients and aerobic exercise training program leads to improvement in autonomic modulation (Borghi-Silva et al., 2009). Hence, aerobic exercise training program can increase exercise tolerance and improvement in anxiety and heart rate of patients. In addition, resistance training in patients with COPD is found to improve respiratory function of patients (Strasser, Siebert, Schobersberger, 2013). Although past studies have proved the benefits of exercise on improving symptoms and quality of life of COPD patients, however this study finding was important to know the difference in outcome in patients with severe and moderate anxiety or depression. There is very few and inconsistent research on analyzing the impact of exercise outcome on patient with different level of severity. The study was done with a total of 42 mixed gender participants. The main outcome of providing 12 week exercise programme to patients with moderate and severe COPD was that significant changes in physiological and psychological scores was seen at baseline and 12 week follow up period. The moderate group showed great improvement in physiological parameters of FEV1, VO2 (Oxygen consumption) and FVC (forced vital capacity). COPD is associated with deteriorating lung function and pulmonary rehabilitation such as exercise training are designed to improve physiological and physical condition of COPD patients. As the major focus was on reduction of anxiety in patients, the 12 week exercise programme was to be useful in positively changing the HADS (Hospital Anxiety and depression score) of patients. The validity of this result can be assessed by comparing it with results of other studies. Consistency in result has been found. Wegner et al., (2014) has shown that depression symptoms is assoc iated with reduction in physical activity in COPD patients and combining resistance training with endurance training improved muscle power and quality of life of patient (Zambom-Ferraresi et al., 2013). Combined training also improved cognitive function in COPD patients thus contributing to high self esteem and high quality of life in patients (Aquino et al., 2016). Another most important result of the research was that it showed that HADS score change uniformly in both groups of participants, however significant improvement in depression could not be achieved. This indicates that physical perception of self affected improvement in depression outcome in participants. Hence, the main conclusion from the study was that exercise based program are useful in improving physiological outcome in patients, however in case of COPD patients with severe symptoms, there is also a need to focus on changing the perception of patients related to management of COPD so that they can take better control on their health condition. Shortness of breath is major symptoms affecting quality of life of patients and this research can be practically applied in COPD patients to improve symptoms breathlessness. Another application of this research in clinical physiology is that it can help to significantly improve the quality of patients with comorbidity of disease. The dura tion and nature of exercise can also be replicated in real setting for patients with moderate symptoms or recent diagnosis of COPD. Despite the success of the research in presenting the difference in outcome of exercise intervention in patients with severe to moderate symptoms of COPD, there are certain limitations in the study too. First limitation that affects the transferability of the research is the small sample size. Secondly, the study was done only with two different severity groups of patients, however no control group was taken. This affected the comparison in study outcome and complete evaluation of intervention. Another limitation was that age specific sample group was not taken which limited getting date related to difference in outcome in older and young patient group. This might contribute to biasness in study results. The duration of the exercise program might also be a limitation as difference in duration of program was not considered for different participants group. Hence, this limitation points out to possible areas of future research on this topic. Firstly, there is a need to do research to i dentify strategies that can help patients with severe COPD to enhance the perception of self. Secondly, there is a need to investigate if longer duration of program such as 24 weeks can affect the outcome of COPD patients or not. There is also a need to identify other combination of exercise intervention that can bring positive outcome for patients with severe symptoms of COPD. References Aquino, G., Iuliano, E., Di Cagno, A., Vardaro, A., Fiorilli, G., Moffa, S., ... Calcagno, G. (2016). Effects of combined training vs aerobic training on cognitive functions in COPD: a randomized controlled trial.International journal of chronic obstructive pulmonary disease,11, 711. Borghi-Silva, A., Arena, R., Castello, V., Simoes, R. P., Martins, L. E. B., Catai, A. M., Costa, D. (2009). Aerobic exercise training improves autonomic nervous control in patients with COPD.Respiratory medicine,103(10), 1503-1510. Strasser, B., Siebert, U., Schobersberger, W. (2013). Effects of resistance training on respiratory function in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.Sleep and Breathing,17(1), 217-226. Topalovic, M., Helsen, T., Troosters, T., Janssens, W. (2016). Unexpected improvements of lung function in chronic obstructive pulmonary disease.Respiratory medicine case reports,18, 81-84. Wegner, M., Helmich, I., Machado, S., E Nardi, A., Arias-Carrion, O., Budde, H. (2014). Effects of exercise on anxiety and depression disorders: review of meta-analyses and neurobiological mechanisms.CNS Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS Neurological Disorders),13(6), 1002-1014. Yohannes, A. M., Alexopoulos, G. S. (2014). Depression and anxiety in patients with COPD.European Respiratory Review,23(133), 345-349. Zambom-Ferraresi, F., Cebollero, P., Gorostiaga, E. M., Hernndez, M., Hueto, J., Cascante, J., ... Anton, M. M. (2015). Effects of combined resistance and endurance training versus resistance training alone on strength, exercise capacity, and quality of life in patients with COPD.Journal of cardiopulmonary rehabilitation and prevention,35(6), 446-453.