Department of Respiratory Medicine, East and North Herts NHS and Primary Care Trusts, Lister Hospital, Stevenage SG1 4AB, UK.
Physiotherapy. 2010 Mar;96(1):68-74. doi: 10.1016/j.physio.2009.04.007. Epub 2009 Jul 24.
To compare the effectiveness of a once-weekly supervised pulmonary rehabilitation programme with a standard twice-weekly format.
Randomised trial of equivalency.
Pulmonary rehabilitation service of a primary care trust delivered at two physiotherapy outpatient departments.
Thirty patients with chronic obstructive pulmonary disease.
Primary outcomes were the Incremental Shuttle Walking Test (ISWT), Endurance Shuttle Walking Test (ESWT) and St George's Respiratory Questionnaire (SGRQ), assessed at baseline and at completion of the supervised programme. Secondary outcomes were home-exercise activity, attendance levels and patient satisfaction with the programme.
The once-weekly group (n=15) received one supervised rehabilitation session per week, and the twice-weekly group (n=15) received two sessions per week, both for 8 weeks, together with a home-exercise plan.
After pulmonary rehabilitation, the groups showed similar improvements in exercise tolerance (median values: ISWT once-weekly 60metres, twice-weekly 50metres; ESWT once-weekly 226seconds, twice-weekly 109seconds). However, for health-related quality-of-life, the once-weekly group's score did not change (SGRQ 0), whereas an improvement was seen for the twice-weekly group (SGRQ 3.7). The number of home-exercise sessions and attendance levels were similar between the groups. Patient satisfaction with both formats was high and almost identical between the groups.
This pilot provides data to inform a larger study and shows that the methodology is feasible. The findings suggest that once-weekly supervision may be capable of producing equivalent improvements in exercise tolerance as a twice-weekly programme, but the health-related quality-of-life outcome appeared to be poorer for once-weekly supervision.
比较每周一次的监督肺康复计划与标准每周两次的格式的效果。
等效性随机试验。
在两个物理治疗门诊部进行的初级保健信托的肺康复服务。
30 名慢性阻塞性肺疾病患者。
主要结果是递增穿梭步行测试（ISWT）、耐力穿梭步行测试（ESWT）和圣乔治呼吸问卷（SGRQ），在基线和监督计划完成时进行评估。次要结果是家庭运动活动、出勤率和患者对计划的满意度。
每周一次组（n=15）每周接受一次监督康复治疗，每周两次组（n=15）每周接受两次治疗，每次 8 周，同时制定家庭运动计划。
肺康复后，两组在运动耐量方面均显示出相似的改善（中位数：每周一次 ISWT 60 米，每周两次 50 米；每周一次 ESWT 226 秒，每周两次 109 秒）。然而，对于健康相关的生活质量，每周一次组的评分没有变化（SGRQ 0），而每周两次组则有所改善（SGRQ 3.7）。两组的家庭运动次数和出勤率相似。两组患者对两种治疗方案的满意度均较高，几乎相同。
本试验提供了数据以支持更大的研究，并表明该方法是可行的。研究结果表明，每周一次的监督可能能够产生与每周两次计划相当的运动耐量改善，但每周一次的监督似乎对健康相关的生活质量结果较差。
