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[Sousse]Physiological Effect of respiratory muscle training in chronic obstructive pulmonary disease patients.
Tunisia (ASSOCIA-MED) - University of Sousse/ Faculty of Medecine of Sousse, Sousse
Laboratory of physiology and function testing, Farhat Hached Hospital Avenue Mohamed Karoui, 4000 – Sousse -TUNISIA
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Chronic obstructive pulmonary disease (=COPD) is a preventable and treatable disease(GOLD, 2017). According to the WHO, COPD would be the third leading cause of death by 2030(WHO, 2017) This disease is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases(GOLD, 2017). However, emerging data showed that COPD patients demonstrate important deficits in balance and control which associated to a high risk of fall ( Butcher et al, 2004 ; Smith et al, 2009 ; Beauchamp et al, 2009 ; Beauchamp et al, 2010) Inspiratory muscle training (IMT) has been shown to be an effective modality for COPD patients for improving the maximal inspiratory muscle strength, the dyspnea and health-related quality of life (GI COPD, 2016)
What is the aim of the project?
The aim is to evaluate the effect of the inspiratory muscles training combined to pulmonary rehabilitation on postural control in COPD: See if this type of training will have positive impact on decreasing sway and risks of fall in this population. Precise whether this type of training improve the exercise tolerance and decrease the breathlessness of the patient.
What techniques and methods are used?
-Pulmonary function testing by spirometry: the measure of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). -Assessment of quality of life (Saint Georges Respiratory questionary): Auto evaluation, the student clarify to the patient the different questions. Calculation of scores -Hospital Anxiety and Depression Scale: Auto evaluation, the student clarify to the patient different questions. Calculation of scores -6 minutes walk test: The The patient was invited to walk as far as possible along a flat corridor. Tests were conducted according to European Respiratory Society/ American Thoracic Society Technical Standard. Dyspnea and breathlessness were measured using Borg scale. The heart rate (HR) and oxygen saturation (SO2) were recorded as well during the test by a portable spiropalm (COSMED, Rome, Italy). At the end of the test, the 6 minutes walking distance (6MWD) was recorded -Assessment of the functional changes in maximal inspiratory pression measured using a MicroRPM -Timed up and go : The patient was initially seated on a standard armchair, sit up walk 3 meters and seat down again. The time is recorded. -Berg balance Scale : The patient is asked to perform 14 situations. The test evaluation was graded from 0 (unsure /unsafe) to 4 (independent/safe) with a maximum score of 56 -Stabilometric platform : The patient is asked to stand up as still as possible barefoot on the platform, with his arms along his body in open eyes and closed eyes conditions. The displacement of centre of pression were recorded.
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
There are many tasks expected to be done by the student: -Medical consultation for every patient participating in the study The student will be supervised and guided by a whole team who will help him/her to accomplish his tasks. -Learn to perform the different tests needed in the study such as pulmonary function testing, 6 minutes walktest, Berg Balance scale, Timed up and go, static balance assessment (performed by stabillometric platform) -Perform the questionnaires used -Statistical analysis: choice of the statistical test ( t student, Mann whitney, Anova, Ancova..) and perform the calculations using Statistical programs
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
yes, the student will attend lectures presented by the tutor.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a presentation
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Knowledge of respiratory physiology as well chronic obstructive diseases
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students
- W Mkacher; Z Tabka; M Makki; Y Trabelsi.Changes in Balance after Rehabilitation Program in Patients with COPD and in Healthy Subjects.Int J Phys Med Rehabil 2 (219); 2
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