Gephine Sarah, Saey Didier, Grosbois Jean-Marie, Maltais François, Mucci Patrick
Université of Lille, Université de Artois, Université du Littoral Cote d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France.
Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada.
Chronic Obstr Pulm Dis. 2022 Jan 27;9(1):15-25. doi: 10.15326/jcopdf.2021.0250.
Daily life disability and vulnerability is often reported in patients with chronic obstructive pulmonary disease (COPD) and chronic respiratory failure. Although pulmonary rehabilitation is feasible in this population, its benefits on functional status and physical frailty is uncertain. This study aimed to evaluate the short- and medium-term effectiveness of a home-based pulmonary rehabilitation program in COPD patients with chronic respiratory failure. We also evaluate the impact of frailty status on the efficacy of the intervention. Forty-seven participants underwent an 8-week home-based program. Functional capacity, physical frailty (Fried criteria), exercise tolerance, health-related quality of life, general fatigue, and anxiety and depressive symptoms were assessed at baseline (M0), and at 8 weeks (M2) and 8 months (M8) following study inclusion. For the group as a whole, functional capacity, physical frailty, health-related quality of life, and fatigue scores were all improved at M2 and M8 (p<0.05), while exercise tolerance and depressive symptoms were only improved at M8 (p<0.01). However, when the group was divided according to frailty status, only the frail patients had improved health-related quality of life, general fatigue, and anxiety and depressive symptom scores after pulmonary rehabilitation (p<0.05). In COPD patients with chronic respiratory failure, home-based pulmonary rehabilitation may be effective for improving functional capacity, physical frailty, and health-related quality of life at short- and medium-term. Physical frailty was not a barrier for benefiting from the intervention, and almost 80% of the patients who were frail prior to the program improved their frailty status after pulmonary rehabilitation.
慢性阻塞性肺疾病（COPD）和慢性呼吸衰竭患者常出现日常生活残疾和脆弱性。尽管肺康复在这一人群中是可行的，但其对功能状态和身体虚弱的益处尚不确定。本研究旨在评估居家肺康复计划对慢性呼吸衰竭COPD患者的短期和中期效果。我们还评估了虚弱状态对干预效果的影响。47名参与者接受了为期8周的居家计划。在基线（M0）、纳入研究后的8周（M2）和8个月（M8）时，评估了功能能力、身体虚弱（Fried标准）、运动耐量、健康相关生活质量、一般疲劳以及焦虑和抑郁症状。对于整个组而言，M2和M8时功能能力、身体虚弱、健康相关生活质量和疲劳评分均有所改善（p<0.05），而运动耐量和抑郁症状仅在M8时有所改善（p<0.01）。然而，当根据虚弱状态对组进行划分时，只有虚弱患者在肺康复后健康相关生活质量、一般疲劳以及焦虑和抑郁症状评分有所改善（p<0.05）。在慢性呼吸衰竭的COPD患者中，居家肺康复在短期和中期可能对改善功能能力、身体虚弱和健康相关生活质量有效。身体虚弱并非从干预中获益的障碍，并且该计划实施前虚弱的患者中近80%在肺康复后虚弱状态得到改善。
