A short outpatient pulmonary rehabilitation programme: immediate and longer term effects on exercise performance and quality of life
A short outpatient pulmonary rehabilitation programme: immediate and longer term effects on exercise performance and quality of life
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DOI：
10.1016/s0954-6111(98)90410-3
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发表时间：
1998-09-01
影响因子：
4.3
通讯作者：
Morgan, MDL
中科院分区：
文献类型：
--
作者：
Singh, SJ;Smith, DL;Morgan, MDL
在北美和欧洲部分地区，慢性阻塞性肺疾病(COPD)患者普遍可以进行肺康复。在这里，我们描述了在英国地区综合医院提供全面但成本效益高的肺康复计划的可行性和好处。267名呼吸障碍患者被转介进行肺康复。患者被评估并被招募到一个为期7周的以门诊患者为基础的肺部康复计划中，其中包括锻炼和教育的元素，而不需要长期的维护。运动表现通过穿梭步行测试和跑步机耐力测试来衡量，生活的二元性通过两种疾病特有的问卷来衡量，即呼吸问题问卷和慢性呼吸系统疾病问卷。在1993至1996年间转诊的267名患者中，132名(110名COPD患者)已完成康复，可以进行评估。所有毕业生的穿梭距离增加了58m(27%)，跑步机耐力时间增加了15.9min(294%)。事实证明，呼吸问题问卷对某些领域的生活质量变化很敏感。慢性呼吸系统疾病问卷显示，在完成问卷的57名患者中，所有领域都有显著改善。49例患者在肺康复后平均10.3个月的长期随访显示，运动能力和生活质量保持了以前的进步，穿梭行走距离改善了33m(比基线改善了14%)，耐力时间改善了16min(比基线改善了280%)。呼吸问题问卷没有总体变化，但慢性呼吸系统疾病问卷显示少数患者继续改善。因此，我们得出的结论是，英国一家地区综合医院的132名患者在没有维持要素的情况下进行短期的门诊肺康复计划，在运动表现和生活质量方面取得了显著改善。
Pulmonary rehabilitation is widely available in North America and parts of Europe for patients with chronic obstructive pulmonary disease (COPD). Here, we describe the feasibility and benefits of providing a comprehensive but cost effective pulmonary rehabilitation programme in a U.K. district general hospital.Two hundred and sixty-seven patients with respiratory disability were referred for pulmonary rehabilitation. Patients were assessed and recruited onto a 7 week outpatient-based pulmonary rehabilitation programme including elements of exercise and education without longer term maintenance. Exercise performance was measured by the shuttle walking test and a treadmill endurance test, and duality of life as measured by two disease specific questionnaires, the Breathing Problems Questionnaire and the Chronic Respiratory Disease Questionnaire. Of 267 patients referred between 1993 and 1996, 132 (110 with COPD) have completed rehabilitation and could be evaluated. For all graduates, shuttle distance increased by 58 m (27%) and treadmill endurance time increased by 15.9 min (294%). The Breathing Problems Questionnaire proved sensitive to changes in quality of life in some domains. The Chronic Respiratory Disease Questionnaire showed significant improvements in all domains in a sub-set of 57 patients who completed it. Longer term follow-up of 49 patients at a mean of 10.3 months following pulmonary rehabilitation revealed that previous gains in exercise performance and quality of life were maintained with improvements in shuttle walking distance of 33 m (14% over baseline) and endurance time of 16 min (280% over baseline). The Breathing Problems Questionnaire showed no overall change but the Chronic Respiratory Disease Questionnaire showed continued improvement in a small number of patients. We therefore concluded that a short outpatient based pulmonary rehabilitation programme without a maintenance element has produced significant gains in exercise performance and quality of life for 132 patients at a district general hospital in the U.K.