Pulmonary Rehabilitation Research Group, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
Respirology. 2013 Oct;18(7):1063-8. doi: 10.1111/resp.12141.
The benefits of pulmonary rehabilitation (PR) are now firmly established. However, less is known about the provision and efficacy of PR immediately after an acute exacerbation of chronic obstructive pulmonary disease (COPD). The study aimed to explore the effectiveness of a short outpatient PR programme and the impact upon readmission rates.
One hundred sixty (87 males) patients, mean (SD) age 70.35 (8.59) years, forced expiratory volume in 1 s 0.99 (0.44) litres were assessed for a 7-week PR programme following a hospital admission for an acute exacerbation of COPD. Patients were assessed and commenced PR within 4 weeks of discharge from hospital. Outcome measures included: Incremental Shuttle Walking Test (ISWT), Endurance Shuttle Walk Test (ESWT), Chronic Respiratory Questionnaire Self-Reported (CRQ-SR). Patients were assessed at baseline and at 7 weeks (after the 4-week supervised and 3-week unsupervised components). Readmission data were collected retrospectively for the 12 months pre and post admission (n = 155).
Statistically significant improvements were found in the ISWT, ESWT and CRQ-SR at discharge (P < 0.05). The number of admission was significantly less in the 12-month post-pulmonary rehabilitation compared to the previous 12 months.
A short course of PR showed improvements in exercise capacity and health status in patients who have had an acute exacerbation of COPD. The number of readmissions was also significantly lower in the year following PR.
肺康复(PR)的益处现已得到充分证实。然而,对于慢性阻塞性肺疾病(COPD)急性加重后立即进行 PR 的情况,人们了解得较少。本研究旨在探讨短期门诊 PR 方案的有效性及其对再入院率的影响。
对 160 名(87 名男性)平均年龄(标准差)为 70.35(8.59)岁、用力呼气量 1 秒 0.99(0.44)升的患者进行评估,这些患者在因 COPD 急性加重住院后接受了为期 7 周的 PR 方案。患者在出院后 4 周内接受评估并开始 PR。评估指标包括:递增式踏车试验(ISWT)、耐力踏车步行试验(ESWT)、慢性呼吸系统问卷自我报告(CRQ-SR)。患者在基线和 7 周时(在 4 周的监督和 3 周的非监督部分后)进行评估。在入院前和入院后 12 个月内(n=155)回顾性收集再入院数据。
在出院时,ISWT、ESWT 和 CRQ-SR 均有显著改善(P<0.05)。与 PR 前的 12 个月相比,PR 后的 12 个月内入院人数明显减少。
短期 PR 可改善 COPD 急性加重患者的运动能力和健康状况。PR 后一年的再入院人数也显著降低。