Shafazand S, Canfield J, Kuschner W G
Pulmonary Section, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Mail Stop 111P, Palo Alto, CA 94304, USA.
Respir Care. 2001 Jun;46(6):595-600.
The conclusion of previous investigations that pulmonary rehabilitation (PR) is an effective intervention for the management of chronic lung disease may not be generalizable to PR programs with limited experience delivering this complex, interdisciplinary service.
Determine whether PR is effective for the first group of patients treated in a newly formed interdisciplinary PR program.
We conducted a longitudinal analysis of changes in health-related quality of life and 6-minute walk test for the first group of patients completing our newly formed 8-week outpatient PR program. We studied 6 men, age 65-77 years, with stable severe chronic obstructive pulmonary disease. Patients completed the Chronic Respiratory Disease Questionnaire immediately before and 1 year after participation in our PR program.
Four patients completed the PR 6-minute walk test both before and after the program. We found improvement in all Chronic Respiratory Disease Questionnaire domains at follow-up (mean +/- SD before and after): dyspnea 1.67 +/- 0.82 vs 4.92 +/- 0.49; emotional function 2.33 +/- 0.82 vs 5.50 +/- 0.55; fatigue 2.00 +/- 0.63 vs 5.00 +/- 0.63; feeling of mastery over disease 1.83 +/- 0.41 vs 5.83 +/- 1.17. The interval improvements in all health-related quality of life domains were statistically significant (p < 0.02 for all comparisons). There was a trend toward improvement in exercise tolerance: 231 +/- 213 ft before PR vs 353 +/- 66 ft at the 1-year follow-up (p = 0.2).
PR can result in sustained improvement in the quality of life of patients with severe chronic obstructive pulmonary disease, even when this complex, interdisciplinary service is delivered by a newly formed and inexperienced PR program.
先前的研究得出结论，肺康复（PR）是治疗慢性肺病的有效干预措施，但这一结论可能不适用于那些在提供这种复杂的跨学科服务方面经验有限的PR项目。
确定PR对新成立的跨学科PR项目治疗的首批患者是否有效。
我们对完成新成立的为期8周门诊PR项目的首批患者的健康相关生活质量变化和6分钟步行试验进行了纵向分析。我们研究了6名年龄在65 - 77岁之间、患有稳定期重度慢性阻塞性肺疾病的男性患者。患者在参加我们的PR项目之前和之后1年立即完成了慢性呼吸系统疾病问卷。
4名患者在项目前后均完成了PR 6分钟步行试验。我们发现随访时慢性呼吸系统疾病问卷所有领域均有改善（前后均值±标准差）：呼吸困难1.67±0.82对4.92±0.49；情绪功能2.33±0.82对5.50±0.55；疲劳2.00±0.63对5.00±0.63；对疾病的掌控感1.83±0.41对5.83±1.17。所有健康相关生活质量领域的间隔改善均具有统计学意义（所有比较p < 0.02）。运动耐力有改善趋势：PR前为231±213英尺，1年随访时为353±66英尺（p = 0.2）。
即使这种复杂的跨学科服务由新成立且缺乏经验的PR项目提供，PR仍可使重度慢性阻塞性肺疾病患者的生活质量持续改善。
