Background: Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), significantly impact patients’ quality of life by limiting physical function, mobility, and overall well-being. Pulmonary rehabilitation (PR), particularly home-based programs, has emerged as a vital non-pharmacological intervention to address these limitations. However, comprehensive assessments of the impact of home-based PR on both lung function and disability in COPD patients remain limited.
Objective: This study aimed to evaluate the effectiveness of a 12-week home-based PR program on pulmonary function and disability in COPD patients, using pulmonary function tests (PFTs) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to assess outcomes across multiple domains.
Methods: A prospective, single-arm pre–post interventional study was conducted among 62 COPD patients at All India Institute of Medical Sciences, Jodhpur. Participants completed a 12-week home-based PR program, which included endurance exercises, breathing techniques, and self-management education. Pulmonary function tests were conducted, and disability levels were assessed using WHODAS 2.0 at baseline and after completing the program.
Results: Improvements were observed in pulmonary function, with forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), showing substantial increases (FVC: 2.50±0.43 L to 2.85±0.59 L; FEV1 1.53±0.33 L to 1.63±0.34 L; P<0.001). The WHODAS 2.0 scores demonstrated notable reductions in disability, particularly in the life activities and participation domains (P<0.001). Cognitive and self-care scores remained stable, while improvements in mobility were observed but not significant. Regression analysis revealed a strong negative correlation between increases in FVC and reductions in WHODAS 2.0 total scores (r=-0.65), highlighting FVC as a key predictor of disability reduction.
Conclusion: The 12-week home-based PR program improved lung function and reduced disability in COPD patients. These findings support the role of home-based PR as a viable, patient-centered alternative to traditional rehabilitation, addressing both physical and social dimensions of health. Future research should focus on long-term outcomes, the potential for broader implementation, and expanding access to underserved populations.
Background and Aims: Irritable bowel syndrome (IBS) poses a significant healthcare challenge, characterized by chronic gastrointestinal and extraintestinal symptoms impacting individuals’ well-being. Treatment preferences may vary among patients from different ethnic groups, such as Arab and Jewish Israelis, necessitating tailored approaches.
Methods: A bilingual (Hebrew/Arabic) questionnaire assessing patients’ preferences regarding treatment goals was developed. It was administered online in Israeli IBS Facebook groups, as well as in two hospital gastroenterology clinics.
Results: The study included 267 IBS patients (91 Arabs and 176 Jews). Demographic analysis revealed a higher proportion of females in both groups, with a significantly greater percentage among Jews compared to Arabs (84% versus 64.8%, respectively, P<0.001). The median age was 32 years for both Arabs and Jews (interquartile ranges of 26–42 and 24–62, respectively). Arabs exhibited higher rates of mixed-type IBS and constipation, while Jews had a higher prevalence of predominant diarrhea IBS. Arabs reported more bloating, higher rates of IBS-related comorbidities, and more medication usage. When asked to rate the importance of treatment goals, both populations preferred improvement in abdominal pain, bloating, and regular defecation, while assigning lower importance to improving difficulty in mental and/or physical aspects of intercourse, as well as arthralgia and myalgia. Arab patients assigned lower importance scores to various symptoms compared to their Jewish counterparts.
Conclusion: This study highlights the impact of ethnicity on patients’ treatment goals. Understanding patients’ preferences will enable tailoring an individual approach to each IBS patient.
Dear Editor, ... The recommendation by Roth and Wald to en-force stricter regalia policies and uphold profession-alism at commencements is crucial. However, such measures should be complemented by proactive educational interventions. ...
