Dalichau S, Demedts A, im Sande A, Möller T
Berufsgenossenschaftliche Unfall-Ambulanz und Reha-Zentrum am Airport Bremen, Bremen.
Rehabilitation (Stuttg). 2010 Feb;49(1):30-7. doi: 10.1055/s-0029-1246154. Epub 2010 Feb 22.
The aim of this study was to evaluate the effects of outpatient medical rehabilitation (OMR) mainly composed of exercise therapy and sports for patients with asbestosis. Following the Hamburg model, the OMR focuses on keeping up lasting effects.
In the frame of a pre-experimental study, 113 male asbestosis patients aged 66.1+/-5.8 years participated 6 hrs. a day five times a week over a period of three weeks in phase 1 of the OMR consisting of evidence-based contents of the pulmonary rehabilitation. Directly after that further therapeutic applications with the main focus on exercise therapy and sports were applied for 3 hrs. once a week over a period of twelve weeks (phase 2). After phase 2 the rehabilitation centre led the patients into sports groups near their places of residence (phase 3). The effects of the OMR were evaluated at the beginning (T1), at the end of phase 1 (T2) and phase 2 (T3) as well as 6 (T4) and 18 months (T5) after T3 by means of a suitable assessment.
Compared to T1 physical fitness (6-minute Walk Test, Hand-Force Test) as well as health-related quality of life (SF-36), dyspnea (BDI/TDI) and oxygen partial pressure (pO2) were significantly improved in T2. These positive effects could be confirmed in T3. 89 patients (79%) were doing health-related sports regularly 6 and 18 months after T3 and could preserve their health outcome in T4 and T5, while the effects of rehabilitation of the 24 patients breaking off any sporting activities wore off again down to and even below the starting condition at T1.
In spite of a restrictive pulmonary disease, specific exercise therapy and sports are able to mobilize physical reserves of performance and induce an increasing quality of life as well as a higher resilience in activities of daily living. These positive effects could be stabilized persistently by a regular training once a week. Thus, the results emphasize the necessity to include strategies of aftercare in the concept of rehabilitation.
本研究旨在评估主要由运动疗法和体育活动组成的门诊医疗康复（OMR）对石棉沉着病患者的影响。遵循汉堡模式，OMR注重维持持久效果。
在一项预实验研究框架内，113名年龄为66.1±5.8岁的男性石棉沉着病患者，在OMR的第1阶段，每周5天，每天参加6小时，为期3周，该阶段包括基于证据的肺康复内容。在此之后，主要侧重于运动疗法和体育活动的进一步治疗应用每周进行1次，每次3小时，为期12周（第2阶段）。第2阶段结束后，康复中心将患者引入其居住地附近的运动小组（第3阶段）。通过适当评估在开始时（T1）、第1阶段结束时（T2）、第2阶段结束时（T3）以及T3后6个月（T4）和18个月（T5）评估OMR的效果。
与T1相比，T2时体能（6分钟步行试验、握力试验）以及健康相关生活质量（SF - 36）、呼吸困难（BDI/TDI）和氧分压（pO2）均有显著改善。这些积极效果在T3时得到证实。T3后6个月和18个月，89名患者（79%）定期进行与健康相关的运动，并能在T4和T5时保持其健康状况，而24名中断任何体育活动的患者的康复效果再次消失，甚至降至T1时的起始状态以下。
尽管存在限制性肺部疾病，但特定的运动疗法和体育活动能够调动身体的运动储备，提高生活质量，并增强日常生活活动的恢复能力。通过每周一次的定期训练，这些积极效果能够持续稳定。因此，研究结果强调在康复概念中纳入后续护理策略的必要性。
