Citations

Purpose: The airway defense mechanism of cough is essential for human survival. Recognition is growing about the distinct role of speech-language pathologists in the nonpharmacological management of various cough disorders. This clinical focus article aims to deliver relevant education about normal and pathological cough to strengthen existing clinical knowledge and skills. Conclusions: The neuronal pathways underlying normal cough function are complex. Cough problems refer to either reduced or heightened cough stemming from various disease processes, and both clinical presentations have detrimental consequences. Current evidence supports that patients who suffer from cough dysfunction benefit from nonpharmacological interventions offered via speech therapy as an adjunct to medical treatments. Speech therapy strategies apply the higher cognitive components of cough by focusing on the deliberate modification and coordination of respiration. Future research priorities are positioned toward improving clinical outcomes for cough disorders.

Abstract Background: Home-based interventions are at the center stage of current healthcare demands. There is a clear need to translate pulmonary rehabilitation to a home-based setting. This 8-week pilot study aimed to determine the feasibility of a Home-based Physical Activity (HPA) program for 12 participants with Chronic Obstructive Pulmonary Disease (COPD) in Sweden. Methods: Patients with COPD, age 40 years or older, and clinically stable in the last 3 months were recruited. The program included the use of a fitness tracker to monitor step count, weekly health coaching calls using motivational interviewing, and video-guided mindful movements (tai chi and yoga exercises). The outcome measures were adherence to the eight-week program video-guided exercises (number of times videos were watched), adherence to health coaching calls (minimum 8), monthly and daily step count, and quality of life (QoL) using the Chronic Respiratory Questionnaire, (CRQ). Results: Thirteen participants were enrolled, and one participant dropped out. Twelve participants adhered to 8-weeks of health coaching calls and step monitoring. We had a total of 643 video-exercise views, the compliance exceeded the minimum standard (576 views). The mean difference comparing total monthly steps from baseline and the eight-week time point was 47 039 steps (CI – 113625-1623.5, p=0.06). The minimal clinical improvement of 500 daily steps was found for 8 of the patients. No significant improvement was found in the QoL measures and mental health. Conclusions: We found the HPA program to be a feasible intervention. Patients showed high adherence to tracking step counts, health coaching calls, and video-guided exercise. No improvements in QoL or monthly step count emerged, however, we found high compliance and a positive trend in the number of monthly step counts, and improvements of at least 500 daily step counts improved in most patients with this small sample size.

Objective: Health coaching has the potential to improve self-management abilities (SM) in patients with Chronic Obstructive Pulmonary Disease (COPD). Patient engagement with health care providers has a beneficial effect on patient outcomes. We examined the association of patient engagement with the health coach on SM abilities in patients with COPD. Methods: We analyzed the association between the degree of engagement measured by the Working Alliance Inventory (WAI-SR) and the SM measured by the Self-Management-Ability-Scale-30 (SMAS-30) at the end of a COPD health coaching intervention. Results: The cohort included 146 moderate to severe COPD patients. The WAI-SR total score was 85% of the maximum possible scores indicating a high degree of engagement between the health coach and the patients. The WAI-SR Task and Bond domains were positively associated with SM abilities after adjusting for lung function (FEV1 %) and depression symptoms (PHQ-2). Conclusion: The degree of engagement between a health coach and patients is associated with the perception of SM abilities in patients with COPD. Our results may inform self-management intervention and clinical practice.