Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Jolly Grant, Dehradun 248140, Uttarakhand, India.
Singapore Med J. 2011 Sep;52(9):689-93.
Pulmonary rehabilitation is now an accepted modality of care in the management of chronic obstructive pulmonary disease (COPD) patients. However, in resource-limited settings, conventional pulmonary rehabilitation may not be feasible due to the high cost involved and the extensive infrastructure requirement. In view of these constraints, we designed a domiciliary pulmonary rehabilitation programme and evaluated its usefulness in the management of severe COPD.
A total of 20 patients suffering from severe COPD (ten patients each in the experimental and control groups) were enrolled in the study. The experimental group was subjected to domiciliary pulmonary rehabilitation along with medical management, while the control group underwent only conventional medical management. During the six-month study period, both groups were assessed for quality of life (clinical COPD questionnaire), exercise capacity (six-minute walk distance) and spirometry values (forced expiratory volume in one second and forced vital capacity).
Statistically significant differences were observed in clinical COPD questionnaire scores in both groups from the fourth month (p-value is 0.002 and 0.001 at the end of four and six months, respectively). The results of the six-minute walk distance showed a similar trend (p-value is 0.009 and 0.001 at the end of four and six months, respectively). No significant difference was observed in either of the spirometry values.
The domiciliary pulmonary rehabilitation programme improves the quality of life and exercise endurance of patients with severe COPD, and thereby acts as a substitute for conventional pulmonary rehabilitation programmes in resource-limited situations.
肺康复目前已被视为慢性阻塞性肺疾病（COPD）患者管理的一种可接受的方法。然而，在资源有限的情况下，由于涉及的高成本和广泛的基础设施需求，常规肺康复可能不可行。鉴于这些限制，我们设计了一种家庭肺康复计划，并评估了其在严重 COPD 管理中的有用性。
共有 20 名患有严重 COPD 的患者（实验组和对照组各 10 名）参与了这项研究。实验组接受家庭肺康复治疗和药物治疗，而对照组仅接受常规药物治疗。在六个月的研究期间，两组均进行生活质量评估（临床 COPD 问卷）、运动能力评估（六分钟步行距离）和肺功能评估（第一秒用力呼气量和用力肺活量）。
两组患者的临床 COPD 问卷评分从第四个月开始均有统计学显著差异（第四个月末的 p 值分别为 0.002 和 0.001，第六个月末的 p 值分别为 0.009 和 0.001）。六分钟步行距离的结果也呈现出类似的趋势（第四个月末的 p 值分别为 0.009 和 0.001，第六个月末的 p 值分别为 0.001 和 0.001）。两种肺功能值均无显著差异。
家庭肺康复计划可提高严重 COPD 患者的生活质量和运动耐力，因此在资源有限的情况下可替代常规肺康复计划。
