Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan.
Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan.
Medicine (Baltimore). 2021 Dec 10;100(49):e28151. doi: 10.1097/MD.0000000000028151.
Pulmonary rehabilitation improves the physical condition of patients with chronic respiratory disease; however, there are patients who cannot leave the hospital because of their low activities of daily living (ADLs), despite the completion of primary respiratory disease treatment and rehabilitation during treatment. Therefore, this study demonstrated that those patients recovered their ADLs through in-hospital pulmonary rehabilitation after treatment completion.
We prospectively studied 24 hospitalized patients who had some remaining symptoms and showed low ADL scores of 9 points or less on the short physical performance battery after undergoing treatment for respiratory disease in Fukujuji Hospital from October 2018 to October 2019, excluding 2 patients who had re-exacerbation and 1 patient who could not be examined using the incremental shuttle walk test (ISWT). After completion of the primary respiratory disease treatment, patients moved to the regional comprehensive care ward, and they received pulmonary rehabilitation for 2 weeks. In the ward, patients who could not yet leave the hospital could undergo pulmonary rehabilitation for up to 60 days. Data were evaluated three times: upon treatment completion (baseline), postrehabilitation, and 3 months after baseline. The main outcome was an improvement in the incremental shuttle walk test (ISWT) postrehabilitation.
The median age of the patients was 80 (interquartile range (IQR): 74.8-84.5), and 14 patients (58.3%) were male. The ISWT distance significantly increased postrehabilitation (median [IQR]: 60 m [18-133] vs 120 m [68-203], P < .001). The Barthel Index (BI) (P < .001), the modified Medical Research Council (P < .001), and other scale scores were also improved. Among patients with acute respiratory diseases such as pneumonia, chronic obstructive pulmonary disease, and interstitial pneumonia, ISWT and other data showed improvement at the postrehabilitation timepoint. Ten patients who could perform examinations at 3 months after baseline were evaluated 3 months after taking baseline data prior to starting rehabilitation. The ISWT showed significant improvement 3 months after baseline compared to baseline (P = .024), and the ISWT distance was maintained after rehabilitation.
Physical activity, symptoms, mental health, and ADL status in patients who had not recovered after primary treatment completion for respiratory diseases could improve through in-hospital pulmonary rehabilitation.
肺康复可以改善慢性呼吸系统疾病患者的身体状况；然而，有些患者尽管在治疗期间完成了主要的呼吸系统疾病治疗和康复，但由于日常生活活动（ADL）能力低下，仍无法出院。因此，本研究表明，这些患者在治疗完成后通过住院肺康复恢复了 ADL。
我们前瞻性研究了 24 名住院患者，他们在 2018 年 10 月至 2019 年 10 月期间在福聚寺医院接受呼吸系统疾病治疗后，仍有一些残留症状，并且在进行简短身体表现电池测试后 ADL 评分低于 9 分（9 分或更低），排除了 2 名再次恶化的患者和 1 名无法进行增量穿梭步行测试（ISWT）检查的患者。在主要呼吸系统疾病治疗完成后，患者转移到区域综合护理病房，并接受为期 2 周的肺康复治疗。在病房中，仍无法出院的患者可接受长达 60 天的肺康复治疗。数据评估了 3 次：治疗完成时（基线）、康复后和基线后 3 个月。主要结果是康复后增量穿梭步行测试（ISWT）的改善。
患者的中位年龄为 80 岁（四分位距（IQR）：74.8-84.5），14 名患者（58.3%）为男性。康复后 ISWT 距离显著增加（中位数[IQR]：60 m [18-133] vs 120 m [68-203]，P <.001）。Barthel 指数（BI）（P <.001）、改良医学研究委员会（P <.001）和其他量表评分也有所改善。在肺炎、慢性阻塞性肺疾病和间质性肺炎等急性呼吸系统疾病患者中，ISWT 和其他数据在康复后时间点显示出改善。10 名可在基线后 3 个月进行检查的患者在开始康复前评估了基线前 3 个月的数据。与基线相比，基线后 3 个月 ISWT 明显改善（P =.024），并且 ISWT 距离在康复后保持。
通过住院肺康复，可改善呼吸系统疾病主要治疗完成后仍未康复的患者的身体活动能力、症状、心理健康和日常生活活动状态。
