Department of Physical Medicine, Balneology and Medical Rehabilitation, Medical Faculty of P. J. Šafárik University and L. Pasteur University Hospital in Košice, Košice, Slovakia.
Department of Physiotherapy, Faculty of Health Care, University of Prešov, Prešov, Slovakia.
Med Sci Monit. 2018 Sep 12;24:6375-6386. doi: 10.12659/MSM.909777.
BACKGROUND We aimed to test the effectiveness of the pulmonary rehabilitation in a mountain environment on the pulmonary function, physical performance, dyspnea, affective factors, and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB), as well as to determine predictors of clinical improvement. MATERIAL AND METHODS 128 consecutive patients (90 diagnosed with COPD and 38 diagnosed with CB) underwent comprehensive pulmonary rehabilitation for a duration of 3 weeks in one of 3 mountain health resorts in the High Tatras. The examination included spirometry (FEV1 and FEV1/FVC), 6-minute walk test (6MWT), Borg scale of dyspnea, and assessment of depression (Zung score), anxiety (Beck score), and QoL using the SF-36 scales. RESULTS After the study intervention, all patients in both monitored groups demonstrated significant improvements in objective measurements in which large treatment effect was achieved (for FEV1 η²=0.218, for 6MWT η²=0.771). Similarly, in subjective measurements a large effect was achieved (for the Beck score: η²=0.599, for the Zung score: η²=0.536). QoL improved after the intervention in all the monitored SF-36 scales in both groups (P<0.001 for all). In patients with COPD, the improvement of exercise capacity was positively correlated with baseline 6MWT and FEV1, and negatively with the Beck anxiety score and the Borg dyspnea score, whereas, only improvement in the mental summary component of QoL was negatively correlated with baseline 6MWT and FEV1 (P<0.05 for all). CONCLUSIONS Rehabilitation in a mountain environment has proven to be effective in both the reported diagnoses of COPD and CB. Improvements in both functional and subjective indicators were observed. These findings support the use of this treatment modality.
我们旨在测试在山区环境中进行的肺康复对慢性阻塞性肺疾病（COPD）和慢性支气管炎（CB）患者的肺功能、身体表现、呼吸困难、情感因素和生活质量（QoL）的有效性，并确定临床改善的预测因素。
128 名连续患者（90 名被诊断为 COPD，38 名被诊断为 CB）在高塔特拉山脉的 3 个山区健康度假村之一接受了为期 3 周的综合肺康复治疗。检查包括肺活量测定（FEV1 和 FEV1/FVC）、6 分钟步行测试（6MWT）、Borg 呼吸困难量表和抑郁（Zung 评分）、焦虑（贝克评分）评估以及使用 SF-36 量表评估 QoL。
在研究干预后，两个监测组的所有患者在客观测量中均表现出显著改善，其中达到了较大的治疗效果（对于 FEV1 η²=0.218，对于 6MWT η²=0.771）。同样，在主观测量中也达到了较大的效果（对于贝克评分：η²=0.599，对于 Zung 评分：η²=0.536）。在两组中，所有监测的 SF-36 量表中的 QoL 在干预后均有所改善（所有 P<0.001）。在 COPD 患者中，运动能力的改善与基线 6MWT 和 FEV1 呈正相关，与贝克焦虑评分和 Borg 呼吸困难评分呈负相关，而只有 QoL 的心理综合成分的改善与基线 6MWT 和 FEV1 呈负相关（所有 P<0.05）。
山区环境中的康复在报告的 COPD 和 CB 诊断中均被证明是有效的。观察到功能和主观指标的改善。这些发现支持使用这种治疗方式。
