Sahin Hulya, Naz Ilknur
a Pulmonary Rehabilitation Unit , Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital , Izmir , Turkey.
b Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences , Izmir Katip Celebi University , Izmir , Turkey.
J Asthma. 2019 Jan;56(1):87-94. doi: 10.1080/02770903.2018.1443468. Epub 2018 Mar 13.
Pulmonary rehabilitation (PR) is an important therapeutic approach in asthmatic patients. Lack of asthma control is associated with high morbidity, poor health outcomes, and decrease in quality of life (QOL). However, there is no clear information about the effectiveness of PR in patients with differing levels of asthma control. This study aimed to compare the efficacy of PR in patients with uncontrolled and partially controlled asthma.
Before undergoing an 8-week outpatient PR program, patients were classified according to the asthma control test (ACT) as having partially controlled asthma or uncontrolled asthma. Changes in asthma control, exercise capacity, dyspnea perception, pulmonary function tests, arterial blood gas analysis, QOL, and psychological symptoms before and after PR were compared between groups.
A total of 49 patients, 21 of whom were in partially controlled and the rest 28 were in uncontrolled asthma, participated in the study. After PR, asthma control perceived dyspnea, exercise capacity, QOL, anxiety, and depression significantly improved in both groups (p < 0.05). When the two groups were compared in terms of the benefits of PR, the improvement in ACT score was significantly greater in patients with uncontrolled asthma than in partially controlled asthma (p < 0.001), whereas the improvements in other parameters were similar between groups (p > 0.05).
Improvement in asthma control is greater in patients with uncontrolled asthma than in patients with partially controlled asthma after PR. Therefore, patients with uncontrolled asthma, in particular, should be given opportunities to benefit from PR programs.
肺康复（PR）是哮喘患者的一种重要治疗方法。哮喘控制不佳与高发病率、不良健康结局及生活质量（QOL）下降相关。然而，关于PR对不同哮喘控制水平患者的有效性尚无明确信息。本研究旨在比较PR对未控制哮喘患者和部分控制哮喘患者的疗效。
在接受为期8周的门诊PR项目之前，根据哮喘控制测试（ACT）将患者分为部分控制哮喘或未控制哮喘。比较两组患者在PR前后哮喘控制、运动能力、呼吸困难感知、肺功能测试、动脉血气分析、QOL及心理症状的变化。
共有49例患者参与研究，其中21例为部分控制哮喘，其余28例为未控制哮喘。PR后，两组患者的哮喘控制、感知呼吸困难、运动能力、QOL、焦虑和抑郁均有显著改善（p<0.05）。在比较两组PR的获益情况时，未控制哮喘患者的ACT评分改善显著大于部分控制哮喘患者（p<0.001），而两组其他参数的改善相似（p>0.05）。
PR后，未控制哮喘患者的哮喘控制改善程度大于部分控制哮喘患者。因此，尤其应给予未控制哮喘患者从PR项目中获益的机会。
