The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.
Institute of The Regional Health University of Southern Denmark, Odense, Denmark.
Disabil Rehabil. 2022 Aug;44(16):4389-4397. doi: 10.1080/09638288.2021.1907455. Epub 2021 Apr 8.
This study aims to investigate the experienced and measured development in physical capacity in people with Chronic Obstructive Pulmonary Disease (COPD) undergoing a standard pulmonary rehabilitation programme with a focus on the diverging experiences of responders and non-responders.
Twenty-one participants in standard pulmonary rehabilitation were included in the study. We measured the participants' change in the six-minute walk test (6MWT) during rehabilitation participation. We investigated their experiences of the changes in their physical capacity by combined participant observations and interviews. A convergent mixed analysis was conducted of the coherent data.
Standard pulmonary rehabilitation had a different physical impact on people with COPD. Responders were delighted by a positive physical change, which improved their daily functioning and capability of fulfilling personal priorities. However, non-responders experienced decreased capacity and a lack of trust in their future. All participants found it challenging to exercise and achieve sustainable exercise habits.
In this qualitative study, we found that absence of expected improvement to pulmonary rehabilitation seems to confer distress and feelings of hopelessness. The achievement of sustainable change in daily exercise behaviour appears yet to be insufficient. Thus, new and more individualized models of physiotherapists' guidance in exercise are imperative.Implications for rehabilitationIt is vital to acknowledge differential response to people with the chronic obstructive pulmonary disease following eight-week standard pulmonary rehabilitation.Especially noteworthy feelings of distress and hopelessness are prominent to non-responders because of the absence of the promised improvements.Both responders and non-responders require intensive physiotherapist guidance to exercise.It is recommended to ensure individualised support to people with chronic obstructive pulmonary disease in rehabilitation programmes.
本研究旨在探讨慢性阻塞性肺疾病（COPD）患者在接受标准肺康复计划治疗时，身体能力的经验和测量发展，重点关注应答者和非应答者的不同体验。
本研究纳入了 21 名参加标准肺康复的参与者。我们测量了参与者在康复参与期间六分钟步行测试（6MWT）的变化。通过结合参与者观察和访谈，我们调查了他们对身体能力变化的体验。对连贯数据进行了收敛混合分析。
标准肺康复对 COPD 患者有不同的身体影响。应答者对积极的身体变化感到高兴，这改善了他们的日常功能和履行个人优先事项的能力。然而，非应答者则经历了能力下降和对未来的缺乏信心。所有参与者都发现锻炼和养成可持续的锻炼习惯具有挑战性。
在这项定性研究中，我们发现肺康复没有达到预期的改善似乎会带来痛苦和绝望感。在日常运动行为中实现可持续的变化似乎还不够。因此，迫切需要新的、更个体化的物理治疗师运动指导模式。
在接受八周标准肺康复治疗后，必须承认 COPD 患者的反应存在差异。由于缺乏承诺的改善，非应答者尤其会出现明显的痛苦和绝望感。应答者和非应答者都需要物理治疗师的强化指导来进行锻炼。建议在康复计划中为慢性阻塞性肺疾病患者提供个性化的支持。
