Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", 28100 Novara, Italy.
Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy.
Int J Environ Res Public Health. 2022 Jul 27;19(15):9150. doi: 10.3390/ijerph19159150.
Pulmonary rehabilitation (PR) is a well-established intervention supported by strong evidence that is used to treat patients affected by chronic respiratory diseases. However, several barriers still affect its spreading in rehabilitation clinical practices. Although chronic respiratory diseases are common age-related disorders, there is still a gap of knowledge regarding the implementation of sustainable strategies integrating PR in the rehabilitation management of frail patients at high risk of respiratory complications. Therefore, in the present study, we characterized the effects of PR in frail patients, highlighting the evidence supporting its role in improving the complex rehabilitative management of these patients. Moreover, we propose a novel organizational model promoting PR programs for frail patients in both inpatient and outpatient settings. Our model emphasizes the role of interdisciplinary care, specifically tailored to patients and environmental characteristics. In this scenario, cutting-edge technology and telemedicine solutions might be implemented as safe and sustainable strategies filling the gap between inpatient and outpatient settings. Future research should focus on large-scale sustainable interventions to improve the quality of life and global health of frail patients. Moreover, evidence-based therapeutic paths should be promoted and taught in training courses promoting multiprofessional PR knowledge to increase awareness and better address its delivery in frail patients.
肺康复(PR)是一种经过充分验证的成熟干预措施,用于治疗患有慢性呼吸系统疾病的患者。然而,一些障碍仍然影响着它在康复临床实践中的推广。尽管慢性呼吸系统疾病是常见的与年龄相关的疾病,但对于在易发生呼吸并发症的体弱患者的康复管理中整合 PR 的可持续策略的实施,仍然存在知识差距。因此,在本研究中,我们描述了 PR 对体弱患者的影响,强调了支持其在改善这些患者复杂康复管理中作用的证据。此外,我们提出了一种新的组织模式,以促进在住院和门诊环境中为体弱患者提供 PR 计划。我们的模型强调了跨学科护理的作用,专门针对患者和环境特点进行定制。在这种情况下,可以实施先进的技术和远程医疗解决方案作为安全和可持续的策略,以弥合住院和门诊环境之间的差距。未来的研究应侧重于大规模的可持续干预措施,以提高体弱患者的生活质量和全球健康水平。此外,应推广循证治疗路径,并在培训课程中教授,以提高对 PR 知识的认识,并更好地为体弱患者提供服务。