Gupta Renu B, Brooks Dina, Lacasse Yves, Goldstein Roger S
University of Toronto, West Park Healthcare Centre, 82 Buttonwood Ave, Toronto, ON, Canada M6M 2J5.
Chest. 2006 Oct;130(4):1089-95. doi: 10.1378/chest.130.4.1089.
The purpose of this study was to evaluate the influence of rollator use on health-related quality of life in patients with COPD.
Randomized controlled trial.
Thirty-one postrehabilitation patients with COPD were randomized to receive a rollator (n = 18) or usual care (n = 13) for 8 weeks and to record the frequency of rollator use. Outcome measures at baseline, 4 weeks, and 8 weeks included the Chronic Respiratory Questionnaire (CRQ) and the 6-min walk (6MW).
During acute testing, subjects consistently walked further when assisted (baseline 6MW: 292 +/- 67 m vs 263 +/- 67 m; 8 weeks: 283 +/- 65 m vs 259 +/- 68 m [+/-SD]; p = 0.013). However, provision of a rollator at home was not associated with group differences in the CRQ (p > 0.08) or in the unassisted 6MW (p = 0.4) or the assisted 6MW (p = 0.5). Eight of 18 subjects assigned to the rollator group used the rollator less than three times per week. Regular users demonstrated a consistent improvement in mastery compared with infrequent users (4 weeks: 4.7 +/- 0.6 vs 5.2 +/- 0.8, respectively; 8 weeks: 5.3 +/- 0.8 vs 4.7 +/- 0.4; p = 0.014).
Despite evidence of effectiveness during acute testing, this study did not demonstrate a rollator effect on quality of life or exercise capacity when the rollator was provided at home, for a longer period. Actual use of a rollator may be an important determinant of its effect. Therefore, when prescribing a rollator, health-care professionals should attempt to identify those most likely to use it.
本研究旨在评估使用助行器对慢性阻塞性肺疾病(COPD)患者健康相关生活质量的影响。
随机对照试验。
31例COPD康复后患者被随机分为两组,一组接受助行器(n = 18),另一组接受常规护理(n = 13),为期8周,并记录助行器的使用频率。在基线、4周和8周时的结局指标包括慢性呼吸问卷(CRQ)和6分钟步行试验(6MW)。
在急性测试期间,受试者在得到辅助时行走距离始终更远(基线6MW:292±67米对263±67米;8周时:283±65米对259±68米[±标准差];p = 0.013)。然而,在家中提供助行器与CRQ组间差异无关(p>0.08),与非辅助6MW(p = 0.4)或辅助6MW(p = 0.5)组间差异也无关。分配到助行器组的18名受试者中有8人每周使用助行器少于3次。与不常使用者相比,经常使用者在掌控感方面持续改善(4周时分别为4.7±0.6对5.2±0.8;8周时为5.3±0.8对4.7±0.4;p = 0.014)。
尽管在急性测试中有有效性证据,但本研究未证明在家中长期提供助行器对生活质量或运动能力有影响。助行器的实际使用情况可能是其效果的重要决定因素。因此,在开具助行器处方时,医护人员应尝试识别最有可能使用它的人群。