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Cystic Fibrosis Exercise , and Quality of Life

Cystic Fibrosis Exercise , and Quality of Life. http://med.stanford.edu/ism/2010/february/cystic-fibrosis-0208.html. http://app1.unmc.edu/publicaffairs/todaysite/sitefiles/today_full.cfm?match=1503. Presented by: John Hardy, Adam Hooten, Andrew Stethen, and Cody Russell.

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Cystic Fibrosis Exercise , and Quality of Life

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  1. Cystic Fibrosis Exercise, and Quality of Life http://med.stanford.edu/ism/2010/february/cystic-fibrosis-0208.html http://app1.unmc.edu/publicaffairs/todaysite/sitefiles/today_full.cfm?match=1503 Presented by: John Hardy, Adam Hooten, Andrew Stethen, and Cody Russell

  2. Becky Foster(Adam Hooten’s Aunt)

  3. P.I.C.O P.- Adults with cystic fibrosis I.- Physical activity C.- Inactivity O.- Decreased hospitalizations and exacerbations http://blog.prashantgorule.com/wp-content/uploads/2011/12/Albert-Einstein-pic.png

  4. Cystic Fibrosis -”inherited disease of the secretory glands” -National Heart, Lung, and Blood Institute -Organs mainly affected: -Lungs -Pancreas -Liver -Intestines -Sinuses -Sex organs http://www.ilquotidianoitaliano.it/gallerie/2011/01/news/chopin-le-sue-allucinazioni-colpa-dell%E2%80%99epilessia-53847.html/

  5. Other Names For Cystic Fibrosis: Andrew Simmons -Cystic Fibrosis of the pancreas -Fibrocystic disease of the pancreas -Mucoviscidosis -Mucoviscidosis of the pancreas -Pancreas fibrocystic disease -Pancreatic cystic fibrosis http://wwewallpaper4u.blogspot.com/2011/11/wwe-umaga-wallpaper.html Nathan Charles http://www.zimbio.com/pictures/Pn8gQIz6yw0/Super+14+Rd+8+Western+Force+v+Stormers/ZsYbhPuhZJe/Nathan+Charles

  6. Epidemiology: • Highest among Caucasians of Northern Europe descent. • Signs and Symptoms- • Variable • Diagnosis- • Series of tests: Cystic Fibrosis Fraser Brown http://tutongkita.blogspot.com/2010/05/kerajaan-baru-uk-dalom-gambar.html

  7. P.I.C.O P.- Adults with cystic fibrosis I.- Physical activity C.- Inactivity O.- Decreased hospitalizations and exacerbations http://discovermagazine.com/2013/september/14-doorway-to-a-cure

  8. Goldbeck 2006 • Results • -QOL is proven directly correlated with hospitalizations and exacerbation. • Conclusion: • -QOL assessments are clinically feasible and practical to monitor in regards to CF

  9. Sahlberg 2008 • Results: • -Max HR remained unchanged • -Max workload and maximal VO2 improved significantly. • Conclusions: • -Endurance training alone improved cardio-pulmonary function

  10. Hebestreit 2010 • Results: • -Intervention group reported significant increase in sports activities • -No difference between groups with reported infections • -Significant intervention effect on peak VO2 • -No significant effect on the QOL scale • Conclusion: • -No long term significant changes in the QOL

  11. Enright 2004 • Results: • -Significant increases in PWC, VC, TLC, Pimax, SPimax • -Decrease in anxiety and depression • Conclusion: • -IMT program resulted in significant benefits for CF pts

  12. Schmidt 2010 • Results: • -Significantly increased VO2Max • -Showed no significant change in QOL except the scores in the domain of treatment burden and emotional functioning • -No significant difference in QOL between exercise group and questionnaire group. • Conclusion: • -Significantly increased VO2Max • -Could not demonstrate improvement in QOL.

  13. Bradley 2006 • Results: • -Evidence supports different types of training including: • resistance and aerobic conditioning. • Conclusions: • -No intervention proven superior to others • -Interventions should be used in conjunction with aerobic • exercise

  14. Abbott 2008 • Results: • -69% of the original participants completed the follow up. • -Higher QOL was associated with better survival. • -Pain and physical functioning domains were statistically • significant. • Conclusions: • -The CFQOL questionnaire is a valid predictor of survival in patients with CF.

  15. Do PT Interventions Positively Affect QOL? Number of Articles -Graphical depiction of article findings. (Abbot, Bradley, Enright, Goldbeck, Hebestriet, Sahlberg, Schmidt)

  16. Summary of Findings • Exacerbations and living circumstances significantly impact QOL. • Physical functioning and pain are important predictors of survival QOL. • Aerobic conditioning can improve cardiovascular function and • psychosocial status. • Little evidenced to support long-term improvements in QOL through exercise and or other PT interventions.

  17. Best intervention is conflicting. • Aerobic Conditioning • Exercise indirectly affects QOL. • Exacerbations = +QOL • Holistic approach needed to produce long-term affects on QOL. • Physical and psychosocial domains. Conclusions/Discussion

  18. Abbott J, Hart A, Morton A, Dey P, Conway S, Webb A. Can health-related quality of life predict survival in adults with cystic fibrosis?. American Journal Of Respiratory And Critical Care Medicine. 2009;179(1):54-58. Available from: MEDLINE, Ipswich, MA. Published January 2009. Accessed September 26, 2013. • Bradley J, Moran F, Elborn S. Evidence for physical therapies in cystic fibrosis: An overview of five Cochrane systematic reviews.Respiratory Medicine. 2006;100(2): 191-201.http://www.sciencedirect.com/science/article/pii/S0954611105005196. Published February 2006.Accessed September 26, 2013. • Enright S, Chatham K, Ionescu A, Unnithan V, Shale D. Inspiratory Muscle Training Improves Lung Function and Exercise Capacity in Adults With Cystic Fibrosis. Chest. 2004;126(2):405-411. Available from: Academic Search Premier, Ipswich, MA. Published August 2004. Accessed September 26, 2013. • Goldbeck L, Zerrer S, Schmitz T. Monitoring quality of life in outpatients with cystic fibrosis: feasibility and longitudinal results. Journal Of Cystic Fibrosis: Official Journal Of The European Cystic Fibrosis Society. 2007;6(3):171-178. Available from: MEDLINE, Ipswich, MA. Published May 2007. Accessed September 26, 2013. • HebestreitH, Kieser S, Kriemler S, et al. Long-term effects of a partially supervised conditioning programme in cystic fibrosis. The European Respiratory Journal. 2010;35(3):578-583. Available from: MEDLINE, Ipswich, MA. Published March 2010. Accessed September 26, 2013. • SahlbergM, Eriksson B, Sixt R, Strandvik B. Cardiopulmonary Data in Response to 6 Months of Training in Physically Active Adult Patients with Classic Cystic Fibrosis. Respiration. 2008;76(4):413-420. Available from: Academic Search Premier, Ipswich, MA. Published November 2008. Accessed September 26, 2013. • Schmidt A, Jacobsen U, OlufSchiøtz P, et al. Exercise and quality of life in patients with cystic fibrosis: A 12-week intervention study. Physiotherapy Theory And Practice. 2011;27(8):548-556. Available from: MEDLINE, Ipswich, MA. Published November 2011. Accessed September 26, 2013. References

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