Eva Moreno

Effects of whole body vibration training in patients with severe chronic obstructive pulmonary disease

To determine if whole body vibration training (WBVT) improves muscular force and modifies functional capacity parameters in patients with severe chronic obstructive pulmonary disease (COPD).

Improving physical activity in patients with COPD with urban walking circuits

BACKGROUND Even after a rehabilitation program, levels of physical activity in COPD progressively decrease unless strategies to encourage activity are implemented. We analyzed the effects of the implementation of urban walking circuits on levels of physical activity and exercise capacity of patients with severe and very severe COPD after a rehabilitation program. METHOD A total of 83 patients were randomized to either urban circuits group (UCG) or usual care in the non-circuit group (NCG), after completing a 2-week rehabilitation program. Results were evaluated 9 months after completion of the rehabilitation program and were compared with a control group of 54 patients not enrolled in the rehabilitation program. RESULTS At the end of follow-up, UCG patients increased their physical activity by a mean of 32.4 (SE = 5.9) min per day and 1.09 (SE = 0.22) days walked per week; 33.9 (SE = 5.6) min per day and 1.12 (SE = 0.24) days per week more compared to the NCG (p < 0.001). There was a significant positive correlation between the results of the 6-min walking test and minutes walked per day in the UCG (r(2) = 0.52, p < 0.05) but not in the NCG (r(2) = 0.094, p > 0.05). Controls showed a significant decrease in exercise capacity and physical activity over the follow-up. CONCLUSIONS Urban circuits are an easy, inexpensive strategy, which demonstrated to be useful to stimulate physical activity in our population of severe and very severe COPD patients and resulted in increased exercise capacity even 9 months after completion of a rehabilitation program.

Factores relacionados con la evolución clínica del síndrome del latigazo cervical

Fundamento y objetivo LOS factores de mala evolucion clinica en el sindrome del latigazo cervical (SLC) no son concluyentes. El objetivo de este estudio longitudinal y prospectivo ha sido identificar aquellos que permitan seleccionar a pacientes con riesgo de desarrollar sintomas cronicos y discapacidad en la fase aguda del SLC. Pacientes y metodo Se incluyo a 226 pacientes con SLC secundario a accidente de trafico, que habian sido remitidos al Servicio de Medicina Fisica y Rehabilitacion para tratamiento medico rehabilitador. Ademas de recoger las variables del protocolo disenado para el estudio, se cumplimentaron la escala visual analogica (EVA) para valorar la intensidad del dolor, la Escala de Depresion y Ansiedad de Goldberg y el Northwick Park Hospital Neck Pain Questionnaire (NPH) para valorar la funcionalidad de la columna cervical en la valoracion inicial y al alta del tratamiento fisioterapico. Resultados LOS factores relacionados con una mala recuperacion del NPH en el momento del alta eran el numero de dias de inmovilizacion cervical con ortesis cervical, presencia inicial de cefalea, vertigo y/o dolor dorsal, valor inicial de la EVA y la Escala de Depresion y Ansiedad de Goldberg. En el analisis multivariado, las variables con influencia estadisticamente significativa sobre el NPH al alta eran la EVA, la subescala de depresion de Goldberg y el NPH de la valoracion inicial. Conclusiones LOS factores que influyen en la evolucion clinica tras un SLC son la valoracion inicial de la intensidad del dolor cervical mediante la EVA, la funcionalidad de la columna cervical mediante el NPH y la subescala de depresion de Goldberg.

Safety of Rehabilitation Program for COPD Patients

Comorbidities n (%) Arterial hypertension 183 (62.8) Dyslipidemia 132 (45.3) SAHS 43 (14.7) Insulin-dependent diabetes mellitus 18 (6.1) Non insulin-dependent diabetes mellitus 45 (15.4) Acute coronary syndrome 58 (19.3) Heart failure 12 (4.1) Atrial fibrillation 35 (12.) Atrial Flutter 9 (3) Pacemaker 8 (2.7) Automatic implantable cardioverter defibrillator 2 (0.8) Stroke transient ischemic attack 3 (1.2) Peripheral Arterial Disease 32 (10.9) Abdominal aortic aneurysm 1 (0.4)

Caminar al menos 30 minutos al día 5 días por semana. ¿Por qué y cómo prescribir ejercicio físico en la enfermedad pulmonar obstructiva crónica?

Eulogio Pleguezuelos , Maria A. Ramon , Eva Moreno e y Marc Miravitlles * a Servicio de Medicina Fı́sica y Rehabilitación, Hospital de Mataró, Mataró, Barcelona, España b Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, España c Servicio de Neumologı́a, Hospital Universitari Vall d’Hebron, Barcelona, España d Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, España e Servicio de Medicina Fı́sica y Rehabilitación, Hospital General de L’Hospitalet, L’Hospitalet de Llobregat, Barcelona, España

How whole-body vibration can help our COPD patients. Physiological changes at different vibration frequencies

Objective Evaluate cardiac, metabolic, and ventilatory changes during a training session with whole-body vibration training (WBVT) with 3 different frequencies in patients with chronic obstructive pulmonary disease (COPD). Methods This was a prospective, interventional trial in outpatients with severe COPD. Participants performed 3 vertical WBVT sessions once a week using frequencies of 35, 25 Hz and no vibration in squatting position (isometric). Cardiac, metabolic, and ventilator parameters were monitored during the sessions using an ergospirometer. Changes in oxygen pulse response (VO2/HR) at the different frequencies were the primary outcome of the study. Results Thirty-two male patients with a mean forced expiratory volume in 1 second of 39.7% completed the study. Compared to the reference of 35 Hz, VO2/HR at no vibration was 10.7% lower (P=0.005); however, no statistically significant differences were observed on comparing the frequencies of 35 and 25 Hz. The median oxygen uptake (VO2) at 25 Hz and no vibration was 9.43% and 13.9% lower, respectively, compared to that obtained at 35 Hz (both comparisons P<0.0001). The median expiratory volume without vibration was 9.43% lower than the VO2 at the end of the assessment at 35 Hz vibration (P=0.002). Conclusion Vertical WBVT training sessions show greater cardiac, metabolic, and respiratory responses compared with the squat position. On comparing the 2 frequencies used, we observed that the frequency of 35 Hz provides higher cardiorespiratory adaptation.

Poster 42 Prognosis Factors Related to Whiplash: A Case Series

compared with the contralateral knee pain score at 3 months (95.5 13.7) and 1 year (95.7 11.6), there was no difference between the 2 knees (P .84 and P .87, respectively). Conclusions: Evaluation of joint specific functional data showed a direct correlation between hip pathology and concurrent IKP. In addition, we observed a dramatic improvement in patient perception of IKP after hip arthroplasty, and patients attained a pain level commensurate to the contralateral side.

Poster 67: What Factors Have Influence on Persistence of Neck Pain After a Whiplash? A Case Series

tion in NPRS scores was also calculated. Results: As early as week 1, 43% of Qutenza-treated patients responded to treatment. At week 2, 44% responded. This response was maintained at week 8, with 48% responders, and at week 12 with 46% responders. At all time points, the Qutenza response rate was significantly greater from control. Similar findings were observed for the proportion of patients with 50% and 2 unit reduction in NPRS scores. During week 1, 27% and 38% of Qutenza-treated patients reported 50% or 2 unit reduction in NPRS scores, respectively. At week 2, 30% and 39% had a 50% or 2 unit reduction. The proportions of Qutenza-treated patients with 50% and 2 unit reduction in NPRS scores were 32% and 42% at week 8 and 30% and 41% at week 12, respectively. At all time points, the 50% and 2 unit response to Qutenza was significantly greater than from the control. Conclusions: Qutenza can provide meaningful pain relief from PHN that can last for 12 weeks after a single 60-minute application.