Hot in Journal CHEST May 2018
By: Dr. Deep Ramachandran
May 7, 2018
Each month, we ask Drs. Chris Carroll and Deep Ramachandran, Social Media Co-Editors of CHEST, to weigh in on the hot topics in CHEST. It's May, so let's hear from Dr. Ramachandran as he outlines his highlights. After reviewing the issue, be sure to share your hot list on our Facebook wall, tweet with the hashtag #journalCHEST, or discuss in the CHEST LinkedIn group.
Eighteen Years Later: Lawsuit Against Big Tobacco Comes to Fruition
Two significant things happened in 1999. First, my niece was born; and second, a lawsuit was launched that alleged that cigarette companies lied about the safety of cigarettes. There were probably other things that happened that year, but those were the big two. She was 7 when that lawsuit was won, and companies were then forced to admit deceptive practices, including marketing to children like her—except that they didn’t.
The companies appealed, and it would not be until she turned 18 that the case was settled and the cigarette makers were forced to admit these practices in several advertisements airing through major media outlets. The win is big for public health, but I can’t help but regret that there will be a generation who did not receive this message. It’s a generation that is now increasingly turning to vape products that have been touted as safer alternatives and are being marketed to minors.
Despite this win, as Drs. McCaffree and Desai point out in this editorial, this is truly no time to rest on our laurels. This is but one victory in a war for public health, in which we must remain ever vigilant. Children born today should not have to wait 18 years for justice.
Tai Chi is Equivalent to Pulmonary Rehab
Pulmonary rehabilitation is well known to improve quality of life in patients with COPD and has even been shown to reduce COPD exacerbations. Tai Chi is a form of martial arts that has taken a foothold among many as a low-impact form of physical therapy. Its therapeutic effects have less to do with self-defense and more to do with slow meditative practicing of form and movements that purportedly have positive effects on mind and body.
In this study, the practice of Tai Chi was compared with a standard pulmonary rehab regimen. Tai Chi was found to be equivalent to classical pulmonary rehab at the end of the initial 12-week training period as measured by the St. George’s Respiratory Questionnaire. Interestingly, 12 weeks after the intervention period, there was significant difference between the two groups. The Tai Chi participants were more likely to maintain their improvements, while the pulmonary rehab participants began to worsen.
The authors theorize that Tai Chi participants were more likely to continue participation in the simple exercises which could be easily performed at home as opposed pulmonary rehab participants who may require access to gym equipment in order to continue.
Listening to Music Improves Exercise Tolerance in COPD
Another fitness article? I feel like we should have called this our inaugural fitness issue! One of the principles of pulmonary rehab is the idea that, through training, patients can be desensitized to the sensation of dyspnea, and therefore better tolerate exercise. While it seems intuitive to anyone who exercises that listening to music helps with exercise tolerance, this effect is not well known in patients with COPD.
Researchers recruited COPD patients from a pulmonary rehab program and then tested their theory by conducting walk tests both with and without music. In the (albeit small) study group participants demonstrated both significantly longer walking times and significantly reduced dyspnea while listening to music. Will Medicare now be mandating required minimum music times during pulmonary rehab? I’m not sure about that, but surely a study looking at the application of music during pulmonary rehab can’t be far off!