Improvements in outcomes for chronic obstructive pulmonary disease (COPD) attributable to a hospital-based respiratory rehabilitation programme
Improvements in outcomes for chronic obstructive pulmonary disease (COPD) attributable to a hospital-based respiratory rehabilitation programme
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DOI：
10.1111/j.1445-5994.1999.tb01589.x
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发表时间：
1999-02-01
期刊：
影响因子：
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通讯作者：
Kolbe, J
中科院分区：
文献类型：
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作者：
Young, P;Dewse, M;Kolbe, J
目的：确定在随机对照研究中选定的受试者中，以医院为基础的呼吸康复方案作为常规临床管理的一部分是否可以实现肺康复的益处。方法：设计：一项前瞻性纵向研究，纳入以医院为基础、无医学监督、门诊、呼吸康复计划的严重慢性阻塞性肺疾病（COPD）患者。康复方案的设计和内容是实用的，由呼吸物理治疗师监督，包括7次2小时的疗程，为期一个月，每组6至8名患者。它包括疾病管理教育、应对技能的实际指导，以及与功能活动有关的特定肌肉训练的渐进式有氧运动方案。在项目开始前、优化药物治疗后、项目结束时、项目结束后3个月和6个月对受试者进行评估。主要结局参数为运动能力（通过6分钟步行距离[MWD]测试评估）、感知呼吸困难程度和生活质量（通过慢性呼吸疾病问卷[CRDQ]评估）。结果：51例重度COPD患者（Fev(1)=0.9+/-0.4 l）完成了该方案。运动能力显著提高（6 MWD测试从基线时的375+/-126米提高到3个月时的440+/-109米）
Aim: To determine whether the benefits of pulmonary rehabilitation, demonstrated in selected subjects in randomised controlled studies, can be achieved by a hospital-based respiratory rehabilitation programme conducted as part of routine clinical management.Methods: Design: A prospective longitudinal study of patients with severe chronic obstructive pulmonary disease (COPD) enrolled in a hospital based, non-medically supervised, outpatient, respiratory rehabilitation programme was undertaken.The rehabilitation programme was of pragmatic design and content, supervised by respiratory physiotherapists and comprised seven two hour sessions over one month for groups of six to eight patients. It included education on disease management, practical instruction in coping skills, as well as a progressive aerobic exercise programme for specific muscle training related to functional activities.Subjects were assessed prior to the programme but after optimisation of pharmacologic therapy, at the completion of the programme and at three months and six months post-programme. Principal outcome parameters were exercise capacity (as assessed by a six minute walk distance [MWD] test), degree of perceived breathlessness and quality of life (QOL) (assessed by the Chronic Respiratory Disease Questionnaire [CRDQ]).Results: Fifty-one subjects with severe COPD (Fev(1)=0.9+/-0.4 l) completed the programme. There was a significant improvement in exercise capacity (a six MWD test improved from 375+/-126 m at baseline to 440+/-109 m at three months, p