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Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions / JESSICA MCCREERY

Swansea University Author: JESSICA MCCREERY

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DOI (Published version): 10.23889/SUthesis.58982

Abstract

Effective rehabilitation strategies are paramount to improve physiological and psychological health in pulmonary disease. The aim of this thesis was to investigate traditional and alternative pulmonary rehabilitation strategies in those with chronic respiratory disease. Chapter Four found that tradi...

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Published: Swansea 2021
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: McNarry, Melitta A. ; Mackintosh, Kelly A.
URI: https://cronfa.swan.ac.uk/Record/cronfa58982
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first_indexed 2021-12-09T12:47:25Z
last_indexed 2021-12-10T04:21:18Z
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spelling 2021-12-09T13:10:21.6565836 v2 58982 2021-12-09 Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions b2c361b8e8dc4f86377bf118fce0ff12 JESSICA MCCREERY JESSICA MCCREERY true false 2021-12-09 Effective rehabilitation strategies are paramount to improve physiological and psychological health in pulmonary disease. The aim of this thesis was to investigate traditional and alternative pulmonary rehabilitation strategies in those with chronic respiratory disease. Chapter Four found that traditional pulmonary rehabilitation (PR) was physiologically and psychologically effective, regardless of respiratory disease, with socioeconomic status being a key determinant of adherence. Chapter Five investigated the feasibility and acceptability of IMT. Children aged 10.8 ± 0.8 years with Cystic Fibrosis (CF) enjoyed the IMT intervention, perceiving improvements in their physical ability and psychosocial health. The care team highlighted that future interventions needed to be longer and to monitor engagement and adherence. Chapter Six assessed the effectiveness of an alternative rehabilitation strategy, using a four-week inspiratory muscle training (IMT) intervention, on lung function and heart rate variability in children with CF aged 10.8 ± 1.1 years. There were significant and clinically meaningful increases in respiratory muscle strength, a clinically meaningful decrease in sympathetic modulation, and decreases in respiratory symptoms. Subsequently, utilising the formative, physiological and psychological findings derived from Chapters Five and Six, an eight-week IMT intervention with live biofeedback, performed at 80% maximal inspiratory pressure, three times a week was implemented, with an eight-week optional IMT top-up. Overall, Chapter Seven found that eight weeks of IMT elicited significant increases in respiratory muscle strength, aerobic capacity and in CF-specific questionnaire domains in children (11.0 ± 2.2 years) with CF, which were maintained following the eight-week top-up period. Chapter Eight demonstrated significant improvements in inspiratory muscle strength and endurance after eight weeks, with sustained improvements in physiological health after 16-weeks in adults with bronchiectasis (64.5 ± 10.3 years). CF and bronchiectasis participants demonstrated high levels of adherence and reported competency and autonomy. Overall, IMT may be an effective and feasible alternative to pulmonary rehabilitation. E-Thesis Swansea Respiratory disease, inspiratory muscle training, pulmonary rehabilitation, bronchiectasis, cystic fibrosis, quality of life, cardiorespiratory 9 12 2021 2021-12-09 10.23889/SUthesis.58982 ORCiD identifier: https://orcid.org/0000-0001-6572-9300 COLLEGE NANME COLLEGE CODE Swansea University McNarry, Melitta A. ; Mackintosh, Kelly A. Doctoral Ph.D 2021-12-09T13:10:21.6565836 2021-12-09T12:27:55.2875117 Faculty of Science and Engineering School of Engineering and Applied Sciences - Uncategorised JESSICA MCCREERY 1 58982__21857__b188c7cf9f9a4c1da42be6e8c44d14d6.pdf McCreery_Jessica_L_PhD_Thesis_Final_Redacted_Signatures.pdf 2021-12-09T13:04:08.9187366 Output 2888787 application/pdf E-Thesis – open access true Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions © 2021 by Jessica L. McCreery is licensed under a CC-BY license. true eng https://creativecommons.org/licenses/by/4.0/
title Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
spellingShingle Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
JESSICA MCCREERY
title_short Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
title_full Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
title_fullStr Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
title_full_unstemmed Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
title_sort Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions
author_id_str_mv b2c361b8e8dc4f86377bf118fce0ff12
author_id_fullname_str_mv b2c361b8e8dc4f86377bf118fce0ff12_***_JESSICA MCCREERY
author JESSICA MCCREERY
author2 JESSICA MCCREERY
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publishDate 2021
institution Swansea University
doi_str_mv 10.23889/SUthesis.58982
college_str Faculty of Science and Engineering
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hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Uncategorised{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Uncategorised
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description Effective rehabilitation strategies are paramount to improve physiological and psychological health in pulmonary disease. The aim of this thesis was to investigate traditional and alternative pulmonary rehabilitation strategies in those with chronic respiratory disease. Chapter Four found that traditional pulmonary rehabilitation (PR) was physiologically and psychologically effective, regardless of respiratory disease, with socioeconomic status being a key determinant of adherence. Chapter Five investigated the feasibility and acceptability of IMT. Children aged 10.8 ± 0.8 years with Cystic Fibrosis (CF) enjoyed the IMT intervention, perceiving improvements in their physical ability and psychosocial health. The care team highlighted that future interventions needed to be longer and to monitor engagement and adherence. Chapter Six assessed the effectiveness of an alternative rehabilitation strategy, using a four-week inspiratory muscle training (IMT) intervention, on lung function and heart rate variability in children with CF aged 10.8 ± 1.1 years. There were significant and clinically meaningful increases in respiratory muscle strength, a clinically meaningful decrease in sympathetic modulation, and decreases in respiratory symptoms. Subsequently, utilising the formative, physiological and psychological findings derived from Chapters Five and Six, an eight-week IMT intervention with live biofeedback, performed at 80% maximal inspiratory pressure, three times a week was implemented, with an eight-week optional IMT top-up. Overall, Chapter Seven found that eight weeks of IMT elicited significant increases in respiratory muscle strength, aerobic capacity and in CF-specific questionnaire domains in children (11.0 ± 2.2 years) with CF, which were maintained following the eight-week top-up period. Chapter Eight demonstrated significant improvements in inspiratory muscle strength and endurance after eight weeks, with sustained improvements in physiological health after 16-weeks in adults with bronchiectasis (64.5 ± 10.3 years). CF and bronchiectasis participants demonstrated high levels of adherence and reported competency and autonomy. Overall, IMT may be an effective and feasible alternative to pulmonary rehabilitation.
published_date 2021-12-09T04:15:56Z
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