Is it really useful to repeat outpatient pulmonary rehabilitation programs in patients with chronic airway obstruction? A 2-year controlled study
Is it really useful to repeat outpatient pulmonary rehabilitation programs in patients with chronic airway obstruction? A 2-year controlled study
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DOI：
10.1378/chest.119.6.1696
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发表时间：
2001-06-01
期刊：
影响因子：
9.6
通讯作者：
Ambrosino, N
中科院分区：
文献类型：
--
作者：
Foglio, K;Bianchi, L;Ambrosino, N
研究目的：为了回答以下问题：在慢性气道阻塞（CAO）患者中，（1）肺康复是否可以在连续的年度干预中获得类似的短期收益，以及（2）每年重复肺康复计划（PRP）是否有任何真实的临床或生理长期获益？设计图：随机对照临床研究。设置：肺康复中心。患者：61名CAO患者在完成最初8周的门诊PRP（PRP 1）后1年进行研究。干预：患者随机分为两组。第一组（第1组）完成了第二次PRP（PRP 2），但第二组（第2组）未完成。一年后，第三次PRP（PRP3）由两组进行测量：肺功能，回旋运动，步行试验，呼吸困难，和健康相关的生活质量（HRQL）进行评估之前和之后的PRP2，之前和之后的PRP3。在过去一年的住院和病情加重的数量也recorded.Results：完整的数据集，从36例患者（17例患者在组1和19例患者在组2）。两组在PRP1前、PRP1后或随机化时的任何参数均无差异。两组的气道阻塞均无显著变化。PRP 2后，第1组的运动耐量、呼吸困难和HRQL改善。然而，1年后，第1组患者与第2组患者的任何结局参数均无差异，因此与PRP 1前相比，PRP 1后24个月，两组中仅HRQL仍较好。与之前2年相比，在PRP 1后2年，两组中每例患者的年住院率和急性加重率均显著降低。然而，在24个月随访访视时，与1个月随访访视时观察到的情况相比，仅在第1组中观察到年度加重进一步减少，但在第2组中未观察到。PRP3导致在两个group.Conclusion运动耐量的改善：在CAO患者，门诊PRP可以实现HRQL的好处，减少住院人数，持续2年。连续的，每年的干预导致类似的短期收益，但不会导致长期的生理效益。进一步减少每年加重似乎是额外PRP的主要受益。
Study objectives: To answer the following questions: in patients with chronic airway obstruction (CAO), (1) can pulmonary rehabilitation lead to similar short-term gains at successive,yearly interventions, and (2) is there any real clinical or physiologic long-term benefit by yearly repetition of pulmonary rehabilitation programs (PRPs)?Design: Randomized, controlled clinical study.Setting: Pulmonary rehabilitation center.Patients: Sixty-one CAO patients studied 1 year after completing an initial 8-week outpatient PRP (PRP1).Intervention: Patients were randomly classified into two groups. A second PRP (PRP2) was completed by the first group (group 1) but not by the second group (group 2). One year later, a third PRP (PRP3) was performed by both groups.Measurements: Lung function, cycloergometry, walking test, dyspnea, and health-related quality of life (HRQL) were assessed before and after PRP2, and before and after PRP3. The numbers of hospitalizations and exacerbations over the year were also recorded.Results: Complete data sets were obtained from 36 patients (17 patients in group 1 and 19 patients in group 2). The two groups did not differ in any parameter either before PRP1, after PRP1, or at randomization. There was no significant change over time for airway obstruction in either group. After PRP2, exercise tolerance, dyspnea, and HRQL improved in group 1. Nevertheless, 1 year later, patients of group 1 did not differ from patients of group 2 in any outcome parameter, such that in comparison to before PRP1, only HRQL was still better in both groups 24 months after PRP1. Yearly hospitalizations and exacerbations per patient significantly decreased in both groups in the 2 years following PRP1, when compared to the 2 years prior. Nevertheless, at the 24-month follow-up visit, a further reduction in yearly exacerbations was observed only in group 1 but not in group 2 in comparison to what was observed at the le-month follow-up visit. The PRP3 resulted in improvement in exercise tolerance in both groups.Conclusion: In patients with CAO, an outpatient PRP can achieve benefits in HRQL and a decreased number of hospitalizations, which persist for a period of 2 years. Successive, yearly interventions lead to similar short-term gains but do not result in additive long-term physiologic benefits. Further reduction in yearly exacerbations seems to he the main benefit of an additional PRP.