The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for individuals with long COVID-19 after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e., baseline, at discharge from in-hospital rehabilitation and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Additionally, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p < 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that the proposed home-based tele-rehabilitation shows potential in enhancing motor and respiratory function in patients with long COVID. Despite limitations such as the small sample size, lack of control group and the preliminary nature of the outcomes observed, the overall findings seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Nevertheless, further research is needed to validate these findings and explore tele-rehabilitation\'s potential in broader and different patient populations.

OBJECTIVE: Posture correction bands (PCBs) have been proposed as aids to help chest expansion and to enhance respiratory function. However, the impact of PCBs on community-based older individuals engaged in inspiratory muscle training (IMT) at home remains unclear.
METHODS: Community-based individuals aged 65 years and older were divided into the PCB group, wearing PCBs, and the NPCB group, not wearing PCBs. The IMT regimen lasted 8 weeks, with sessions 5 times a week, including 4 sets per day and 15 repetitions per set. Training intensity was set at 50% of the maximum inspiratory pressure of each subject. To assess the effects of IMT, respiratory function, 6-minute walk test, and grip strength were measured before, during, and after the training period. Data were analyzed using repeated-measures analysis of variance, with post-hoc evaluation employing Bonferroni correction.
RESULTS: A total of 40 subjects were evenly divided into the PCB group and the NPCB group, with 20 subjects in each group. No significant difference was observed in respiratory muscle strength based on PCB use. However, during the initial 4 weeks, the PCB group exhibited a trend towards an increase in respiratory muscle strength compared to the NPCB group; this trend, however, did not prove to be statistically significant by the end of the 8-week period. Performance on the 6-minute walk test significantly improved in both groups.
CONCLUSIONS: The PCB group exhibited a tendency for increase in respiratory muscle strength in the first 4 weeks; however, ultimately there was no significant difference compared to the NPCB group.
BACKGROUND: This study was registered with the Clinical Research Information Service, part of the World Health Organization\'s International Clinical Trials Registry Platform (Clinical Research Information Service No. KCT0008075).

BACKGROUND: Lung transplant (LT) is the ultimate option for end-stage lung diseases. Malnutrition and sarcopenia, common in LT recipients, can be reversible with adequate exercise and nutrition. This study aims to assess changes in physical performance and aerobic capacity after a 10-week rehabilitation program (RP) in LT recipients, as well as to describe the prevalence of sarcopenia and malnutrition before and after RP and their influence on clinically relevant outcomes.
METHODS: Quasi-experimental study, before and after a 10-week PR in first-time TP recipients, aged over 18 years, from January 2022 to September 2023. Aerobic exercise capacity was assessed through the 6-minute walking test (6MWT) and peak oxygen consumption (VO2peak); and physical performance was measured using the Short Physical Performance Battery (SPPB). Additionally, the prevalence of sarcopenia was described according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2) and malnutrition according to the criteria of the Global Leadership Initiative on Malnutrition (GLIM).
RESULTS: Of the 41 patients, 56% had sarcopenia and 80% had malnutrition. After RP, the distance walked in the 6MWT increased by 66.3m (p=0.004) in men and 61m (p=0.001) in women. VO2peak increased in men by a mean of 3.1ml/min/kg (p=0.024). Physical performance improved significantly in both men and women according to the Short Physical Performance Battery (SPPB), with clinically relevant differences of 1.6 pts (p<0.001) and 1.2 pts (p=0.012), respectively. The prevalence of sarcopenia decreased to 24% and malnutrition to 61%.
CONCLUSIONS: RP proved to be an effective and safe intervention for LT recipients. In addition to improvements in skeletal muscle strength and exercise capacity, a reduction in the prevalence of sarcopenia and malnutrition was also observed.

The COVID-19 epidemic has made significant changes in the organization of treatment process both at the inpatient and outpatient stages.
OBJECTIVE: To analyze the work results of the rehabilitation units dealing with patients who have suffered from COVID-19, in order to summarize the used approaches to medical rehabilitation and improve the effectiveness of care delivery in the recovery phase.
CONCLUSIONS: Currently, the rehabilitation system has been effectively rebuilt to meet new challenges of the COVID-19 pandemic. Recovery of patients with pronounced neurotic disorders has become a showing good results direction in rehabilitation. It is necessary to implement a tight integration of physical exercises and telerehabilitation facilities in order to effectively settle the main issues directly related to the treatment and recovery of patients with COVID-19 and other pathologies. The control, prevention, treatment and rehabilitation of other infectious diseases will have great prospects regarding the possibility of remote follow-up of patients and correction of their functional state of the body in the nearest future.
Эпидемия COVID-19 внесла существенные коррективы в организацию лечебного процесса как на стационарном, так и на амбулаторном этапах.
UNASSIGNED: Провести анализ результатов работы реабилитационных подразделений, занимающихся пациентами, перенесшими COVID-19, с целью обобщения применяемых подходов к медицинской реабилитации и повышения эффективности оказания помощи на этапе восстановления.
UNASSIGNED: В настоящее время система реабилитации эффективно перестроилась под новые вызовы пандемии COVID-19. Направлением в реабилитации, демонстрирующим хорошие результаты, стало восстановление пациентов с выраженными невротическими расстройствами. Для эффективного решения основных вопросов, непосредственно связанных с лечением и восстановлением пациентов с COVID-19 и другими патологиями, необходимо осуществить плотную интеграцию физических упражнений и средств телереабилитации. В ближайшем будущем контроль, профилактика, лечение и реабилитация других инфекционных заболеваний будут иметь большие перспективы в отношении возможности дистанционного динамического наблюдения за пациентами и коррекции их функционального состояния организма.

UNASSIGNED: Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD.
UNASSIGNED: Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes.
UNASSIGNED: There were no consistent statistically significant differences between groups for the lung function outcomes (p\\<0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (p\\<0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (p=0.005) and six and nine months for maximal expiratory pressure (p=0.027 and p\\<0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (p>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (p\\<0.05).
UNASSIGNED: Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles.
UNASSIGNED: Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.

BACKGROUND: Due to a high number of patients affected by long COVID or post-COVID condition, an essential step to address the long-term effects of COVID-19 lies in the development and implementation of flexible and accessible rehabilitation programs. Virtual reality (VR) technologies offer the potential to support traditional therapies with individualized at-home programs.
OBJECTIVE: This study aims to provide an overview of existing scientific evidence on the development and implementation of VR-assisted respiratory rehabilitation programs for patients with long COVID and post-COVID condition and to synthesize the results.
METHODS: We conducted a scoping review of studies from 6 databases. PubMed, CINAHL, Cochrane, ScienceDirect, Web of Science Social Sciences Citation Index, and PEDro were searched using an exploratory search strategy. The search, which was last updated in February 2024, included peer-reviewed studies on immersive VR applications providing respiratory rehabilitation programs for patients with chronic obstructive pulmonary disease and long COVID or post-COVID condition. Exclusion criteria were studies in clinical or inpatient settings, telemedicine, nonimmersive VR applications, and gray literature. Nine publications were included in this review. Findings were extracted and summarized from the studies according to the JBI (Joanna Briggs Institute) method and thematically categorized. Topics covered were study characteristics, physiotherapeutic concept, clinical parameters, as well as usability and acceptability.
RESULTS: The 9 publications included in the qualitative analysis were published in 2019-2023. Eight empirical studies were included: 4 followed a mixed methods design, 3 were qualitative studies, and 1 followed a quantitative method. One scoping review was included in the data analyses. Four of the included studies were on patients with chronic obstructive pulmonary disease. The 9 studies demonstrated that VR-supported respiratory rehabilitation programs result in positive initial outcomes in terms of physical as well as psychological parameters. Particularly noteworthy was the increased motivation and compliance of patients. However, adverse effects and lack of usability are the barriers to the implementation of this innovative approach.
CONCLUSIONS: Overall, VR is a promising technology for the implementation of individualized and flexible respiratory rehabilitation programs for patients with long COVID and post-COVID condition. Nevertheless, corresponding approaches are still under development and need to be more closely adapted to the needs of users. Further, the evidence was limited to pilot studies or a small number of patients, and no randomized controlled trials or long-term studies were part of the study selection. The included studies were performed by 4 groups of researchers: 3 from Europe and 1 from the United States.

UNASSIGNED: Whether Internet of Things (IoT)-based home respiratory muscle training (RMT) benefits patients with comorbid chronic obstructive pulmonary disease (COPD) remains unclear. Therefore, this study aims to evaluate the effectiveness of IoT-based home RMT for patients with COPD.
UNASSIGNED: Seventy-eight patients with stable COPD were randomly divided into two groups. The control group received routine health education, while the intervention group received IoT-based home RMT (30 inspiratory muscle training [IMT] and 30 expiratory muscle training [EMT] in different respiratory cycles twice daily for 12 consecutive weeks). Assessments took place pre-intervention and 12 weeks post-intervention, including lung function tests, respiratory muscle strength tests, the mMRC dyspnea scale, CAT questionnaires, the HAMA scale, and 6-month COPD-related readmission after intervention.
UNASSIGNED: Seventy-four patients with COPD were analyzed (intervention group = 38, control group = 36), and the mean age and FEV1 of the patients were 68.65 ± 7.40 years, 1.21 ± 0.54 L. Compared to those of the control population, the intervention group exhibited higher FEV1/FVC (48.23 ± 10.97 vs 54.32 ± 10.31, p = 0.016), MIP (41.72 ± 7.70 vs 47.82 ± 10.99, p = 0.008), and MEP (42.94 ± 7.85 vs 50.29 ± 15.74, p = 0.013); lower mMRC (2.00 [2.00-3.00] vs 1.50 [1.00-2.00], p < 0.001), CAT (17.00 [12.00-21.75] vs 11.00 [9.00-13.25], p < 0.001), and HAMA (7.00 [5.00-9.00] vs 2.00 [1.00-3.00], p < 0.001) scores; and a lower incidence rate of 6-month readmission (22% vs 5%, p = 0.033).
UNASSIGNED: Compared with no intervention, IoT-based home RMT may be a more beneficial intervention for patients with COPD.

Background The volume-oriented incentive spirometer is a specialized device designed to facilitate maximal inspiration, promote deep breathing exercises, and enhance lung function. The use of spirometry is challenging and not proven in patients with tracheostomy. Therefore, this study aimed to assess the impact of volume-oriented incentive spirometry on lung volume and peak expiratory flow rate (PEFR) in patients with tracheostomy. Methodology All adult patients with cuffed tracheostomy tubes with a Medical Research Council (MRC) score of more than 48 were studied. Volume-oriented incentive spirometry was performed and the PEFR was measured before and after the spirometry session. All patients underwent 28 sessions in seven days with initial few training sessions. Patient demographic information, such as age, gender, reasons for tracheostomy, MRC at the beginning of the session, volume (volume per breath, mL), and PEFR, was documented. Results Thirty patients were studied, consisting of 18 males and 12 females with initial MRC scores ranging from 48 to 60. The mean lung volume and mean PEFR at the end of seven days were 950 ± 330.9 and 134.7 ± 63.3, respectively, demonstrating safety with minimal complications, including four cases of pain at the tracheostomy site, three cases of hypotension, one case of abdominal pain, and 22 cases with no reported complications. Conclusion Volume-oriented incentive spirometry improves lung volume and PEFR in patients with a tracheostomy tube. Additionally, spirometry proved to be both feasible and effective in this patient population.

Metabolic syndrome (MetS) is a combination of metabolic disorders that concurrently act as factors promoting systemic pathologies such as atherosclerosis or diabetes mellitus. It is now believed to encompass six main interacting conditions: visceral fat, imbalance of lipids (dyslipidemia), hypertension, insulin resistance (with or without impairing both glucose tolerance and fasting blood sugar), and inflammation. In the last 10 years, there has been a progressive interest through scientific research investigations conducted in the field of metabolomics, confirming a trend to evaluate the role of the metabolome, particularly the intestinal one. The intestinal microbiota (IM) is crucial due to the diversity of microorganisms and their abundance. Consequently, IM dysbiosis and its derivate toxic metabolites have been correlated with MetS. By intervening in these two factors (dysbiosis and consequently the metabolome), we can potentially prevent or slow down the clinical effects of the MetS process. This, in turn, may mitigate dysregulations of intestinal microbiota axes, such as the lung axis, thereby potentially alleviating the negative impact on respiratory pathology, such as the chronic obstructive pulmonary disease. However, the biomolecular mechanisms through which the IM influences the host\'s metabolism via a dysbiosis metabolome in both normal and pathological conditions are still unclear. In this study, we seek to provide a description of the knowledge to date of the IM and its metabolome and the factors that influence it. Furthermore, we analyze the interactions between the functions of the IM and the pathophysiology of major metabolic diseases via local and systemic metabolome\'s relate endotoxemia.

OBJECTIVE: To explore the application effect of competency-based education (CBE) combined with multi-disciplinary team (MDT) teaching mode in respiratory rehabilitation nursing teaching.
BACKGROUND: Respiratory rehabilitation, as an important non drug treatment for chronic respiratory disease, started late in China, with low implementation rate in hospitals and insufficient knowledge of nursing staff. Therefore, it is urgent to cultivate high professional level nurses with strong professional ability.
METHODS: A randomized controlled trial.
METHODS: We selected nurses from the respiratory and critical care department at a Grade III, Level A hospital in Beijing, who participated in the respiratory rehabilitation training program between March 2020 and August 2022, as our study participants. Participants were grouped using a random number method. Nurses who participated in the study from March 2020 to May 2021 were set as the control group, and the nurses who participated in the study from June 2021 to August 2022 were set as the test group. The control group used traditional teaching methods, and the test group used the CBE combined MDT teaching model. At the end of the test, the theory, operating skills, satisfaction and core competence were assessed.
RESULTS: After training, the theoretical examination score of the test group (93.71 ± 1.94) was higher than that of the control group (92.37 ± 1.92), the operational examination score of the test group (93.11 ± 2.12) was higher than that of the control group (91.61 ± 1.93), the overall teaching satisfaction of the test group (4.45 ± 0.50) was higher than that of the control group (4.13 ± 0.57), and the total score of the core competence of the test group (148.73 ± 7.08) was higher than that of the control group (141.02 ± 6.41). The difference between the two groups was statistically significant (P<0.05).
CONCLUSIONS: CBE combined with MDT teaching mode has a good effect in Pulmonary and Critical Care Medicine (PCCM) respiratory rehabilitation nursing teaching.