A Comparative Study of Three Portable Oxygen Concentrators During a 6-Minute Walk Test in Patients With Chronic Lung Disease.

A Comparative Study of Three Portable Oxygen Concentrators during a 6-Minute Walk Test in Patients with Chronic Lung Disease.

Respir Care. 2013 Apr 2;
Leblanc CJ, Lavallée LG, King JA, Taylor-Sussex RE, Woolnough A, McKim DA

Background-The purpose of this study was to compare the ability of 3 portable oxygen concentrators (POCs) to maintain SpO2 ? 90% during exercise in patients with chronic lung disease (CLD).Methods-Twenty-one participants with CLD (18 COPD, 3 PF) and documented room air exertional SpO2 ? 85% performed four, 6-minute walk tests (6MWTs): a control walk using the participant’s current oxygen system and prescribed exertional flow rate and 1 walk with each of the 3 POCs at maximum pulse dose setting.Results-There was a significant interaction between POC type and time point for SpO2 measurements with higher saturations pre- and post- walk when participants used the Eclipse 3 when compared to the other POCs (all p<0.01). Participants were also able to walk further and maintain a mean SpO2 ? 90% while using the Eclipse 3 (both p<0.01), the device with the largest bolus size. Participants indicated that they preferred the EverGo's physical characteristics but that the Eclipse 3 responded best to their breathing. The iGo was rated less favourably than the other 2 POCs.Conclusions-The Eclipse 3, with the largest bolus size of the POCs tested, was best at meeting patients' clinical needs. POC recipients should be appropriately tested during all activities of daily living to ensure adequate oxygenation. The health care provider should provide information and help direct the patient toward the most clinically appropriate oxygen system while being mindful of the patient's preferences and lifestyle. This study was registered with clinicaltrials.gov, trial number NCT01653730. HubMed – rehab

Inpatient rehabilitation outcome: a matter of diagnosis?

Neuropsychiatr Dis Treat. 2013; 9: 253-7
Bejor M, Ramella FC, Toffola ED, Comelli M, Chiappedi M

Patients with comorbidities are becoming more and more common in Italian rehabilitative wards. These comorbidities are considered a major problem for inpatient rehabilitation, due to the fact that they cause longer lengths of stay, higher costs, and lower functional results.To investigate the possible relationships between comorbidity, functional impairment, age, and type of discharge in patients hospitalized in postacute rehabilitation facilities, we planned an observational study. A total of 178 consecutive inpatients (average age: 78 years [range: 39-99]) from postacute rehabilitation facilities were recruited. Primary diagnosis, comorbidity rating (Cumulative Illness Rating Scale – Geriatric version, CIRS-G) and functional impairment score (Functional Independence Measure, FIM™) were evaluated at admission. The FIM™ rating was also assessed at hospital discharge.A total of 178 of the 199 enrolled patients completed the rehabilitation treatment (89.4%). The average length of stay was 46 ± 24 days. CIRS-G showed an average comorbidity score for each patient of 4.45 ± 1.69. The average FIM™ rating was 79 ± 24.88 at admission, and 91.9 ± 25.7 at discharge. Diagnosis at admission (grouped according to the International Classification of Diseases 9-CM) seemed to correlate with functional results, since lower rehabilitative efficiency was obtained for patients who had a history of stroke.The number and type of comorbidities (CIRS-G) in rehabilitation inpatients do not seem to affect functional outcomes of treatment. The determining factor for a lower level of functional recovery seems to be the diagnosis at admission. HubMed – rehab

Characteristics of corticospinal tract area according to pontine level.

Yonsei Med J. 2013 May 1; 54(3): 785-7
Seo JP, Jang SH

Diffusion tensor imaging (DTI) allows to isolate the corticospinal tract (CST) area from adjacent structures. Using DTI, we investigated the characteristics of the CST areas according to the pontine level in the normal human brain. We recruited 33 healthy subjects and DTIs were acquired using a sensitivity-encoding head coil on a 1.5-T Philips Gyroscan Intera. We measured the size and fractional anisotropy (FA) value of the CST area at the upper, middle, and lower pons. The size of the CST area in the lower pons was smaller than those of the mid-pons and upper pons, and the size of the CST area in the mid-pons was smallerthan that of the upper pons (p<0.05). FA values of the lower pons were larger than those of the mid-pons and upper pons, and the FA value of the mid-pons was also larger than that of the upper pons (p<0.05). In summary, we found a smaller size and higher FA value of the CST area from rostral to caudal direction in the pons. These results suggest a more compact neural structure of CST areas from rostral to caudal direction in the pons. HubMed – rehab