Department of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt.
J Cardiopulm Rehabil Prev. 2009 Jul-Aug;29(4):255-60. doi: 10.1097/HCR.0b013e3181a814fa.
Pulmonary rehabilitation (PR) programs have been shown to improve functional status, exercise performance, and quality of life (QOL) and decrease perception of exertion in individuals with chronic obstructive pulmonary disease. The purpose of this study was to identify the dose effect of PR on the outcome variables of activity level, perceived exertion, and physical and mental QOL.
The study used a retrospective explanatory design. The sample (N = 104) included records of individuals diagnosed with chronic bronchitis and emphysema who attended a PR program from 2000 to 2005 at a Midwest inner-city, academic medical center. Participants attended rehabilitation sessions 2 to 3 days per week for approximately 90 minutes each day; maximum duration of the program was 3 months (24 sessions). The PR dose was calculated by multiplying the number of PR sessions with the number of weeks attended.
There were 32 men and 72 women, with a mean age of 59.9 years +/- 10.2 years. All patients were retired or unemployed, and 99% used oxygen during exercise. A higher PR dose was significantly related to improvement in activity level measured by maximum metabolic equivalent (MET) level achieved. A nonsignificant but minimally clinically important difference was found on the Medical Outcomes Study Short-Form 36 (SF-36) outcomes of mental and physical QOL.
The findings of the current study support a significant relationship between PR dose and activity level (maximum MET level achieved). Physical and mental QOL improved clinically after PR. Optimal program outcomes were related to greater patient participation in supervised PR.
肺康复（PR）计划已被证明可以改善慢性阻塞性肺疾病患者的功能状态、运动表现和生活质量（QOL），并降低其用力感知。本研究的目的是确定 PR 对活动水平、感知用力和身体及精神 QOL 等结果变量的剂量效应。
本研究采用回顾性解释性设计。样本（N=104）包括 2000 年至 2005 年期间在中西部市中心学术医疗中心参加 PR 计划的慢性支气管炎和肺气肿患者的记录。参与者每周参加 2-3 天的康复课程，每天大约 90 分钟；该计划的最长持续时间为 3 个月（24 节课）。PR 剂量通过将 PR 课程的数量乘以参加的周数来计算。
共有 32 名男性和 72 名女性，平均年龄为 59.9 岁 +/- 10.2 岁。所有患者均已退休或失业，99%的患者在运动时使用氧气。更高的 PR 剂量与最大代谢当量（MET）水平所衡量的活动水平的改善显著相关。在医疗结果研究短型 36 项（SF-36）的精神和身体 QOL 结果上发现了无统计学意义但具有临床意义的微小差异。
本研究的结果支持 PR 剂量与活动水平（最大 MET 水平）之间的显著关系。PR 后身体和精神 QOL 得到了临床改善。最佳的计划结果与患者更多地参与监督 PR 有关。
