Optimizing physical activity and work participation in individuals with chronic obstructive pulmonary disease
Notice bibliographique
Résumé
Chronic Obstructive Pulmonary Disease (COPD) is a systemic disease associated with disabling dyspnea, reduced exercise capacity,and increased mortality. As symptoms get worse, individuals with COPD become less physically active and therefore, more deconditioned. The loss of physical function entails a corresponding loss in lifestyle and social roles, leading to a decrease in quality of life. Effective management of the disease includes rehabilitation aiming at increasing exercise and physical activity (PA), maximizing function to the highest level possible within the limitations inherent to the disease in order to improve quality of life. The overall objectives of this thesis were: i) to maximize by new management approaches exercise training and long-term adherence to PA behaviour in individual with COPD by contributing to evidence of new models of exercise and self-management (SM) support tailored to patients' needs and capacities, and ii) to improve our understanding of COPD with respect to work participation and to better identify individuals at risk.The first study consists of a randomized controlled trial comparing the effects of eccentric and concentric cycle training on quadriceps muscle strength and functional outcomes in advanced COPD. Eccentric cycle was associated with greater relative improvements in quadriceps strength and similar gains in exercise capacity, but with lower sensations of dyspnea when compared with concentric cycling. The second study demonstrates the systematic development of a theory-informed web-based intervention to support SM of PA in COPD. We developed an interactive and theory-informed intervention. The third study tested the acceptability and usability of a web-based PA intervention from the perspective of COPD patients. The web-based intervention was acceptable and usable by COPD patients, resulting in short-term improvements in daily step counts. In addition, opportunities to refine the intervention and solve usability issues were identified.The fourth study evaluated work productivity loss in COPD subjects categorized according to the GOLD ABCD classification in comparison to non-COPD subjects, and it estimated the predictive value of clinical measures such as symptom burden and exacerbations. This study was embedded in a population-based, longitudinal study, the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Our results showed that work productivity loss is higher in COPD subjects with high symptom burden in comparison to those with low symptom burden and non-COPD subjects, emphasizing the validity of the ABCD GOLD classification and the validity of the CAT questionnaire. The findings of the studies presented in this thesis suggest that ECC could be an alternate and/or adjunct exercise training modality for pulmonary rehabilitation in patients with advanced COPD. In addition, by employing a user-centered design approach, a theory-informed web-based physical activity intervention including activity monitoring, feedback and education was found to be easy to use and to have the potential to promote daily PA behavior in subjects with COPD. Future work will be required to test the effectiveness of these treatment strategies in a larger controlled clinical trial. Finally, the societal burden of COPD individuals with high burden calls for further awareness of the relevance of early recognition and optimal treatment of individuals with mild to moderate COPD. Challenges to the implementation of these interventions are presented.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».