Yu Zhenjie, He Jingchun, Wu Jie, Di Xia, Wang Xiaohui, Dong Ming, Li Qi, Yu Lili, Liu Jun, Wang Lan
School of Nursing, Tianjin Medical University, Tianjin, China.
Department of Respiratory and Critical Care Medicine, Tianjin Fourth Central Hospital, Tianjin, China.
J Thorac Dis. 2023 Dec 30;15(12):7100-7111. doi: 10.21037/jtd-23-964. Epub 2023 Dec 26.
Chronic obstructive pulmonary disease (COPD) is characterised mainly by exertional dyspnoea, which may lead to activity reduction. Pulmonary rehabilitation (PR) is considered capable of mitigating these impairments. However, access to PR is limited to specialised centres, especially during the coronavirus disease 2019 pandemic. Moreover, low-cost home rehabilitation programmes have non-individualised prescriptions, which might lead to inconsistent clinical effects in patients with COPD. Therefore, it is important to develop new, low-cost protocols involving individualised prescriptions and staff supervision.
This is a descriptive protocol for a randomised controlled study at the Grade III A Hospital in Tianjin. The sample size was calculated according to a described formula. Fifty-six participants will be selected and randomly allocated into two groups: (I) control (traditional PR training, medication, and nursing interventions); and (II) intervention [PR training in the hospital and at home by the Cardiopulmonary Rehabilitation System Management Platform (CSM)]. The protocol will be performed twice a week for 8 consecutive weeks in the outpatient clinic, and the training will be performed by the application of the CSM system in the final 6 months of the trial. The study will assess lung function and physical fitness and analyse the scores of the modified Medical Research Council Dyspnoea Scale, the COPD assessment test, the International Classification of Functioning, Disability, and Health, and the 6-minute walk test before and after the training protocol. Comparison of differences will be performed using repeated measures analysis of variance, a linear mixed effects analysis, or a non-parametric test, which will include only participants who completed all outcome measures and followed the intervention protocol. The study results will be disseminated through presentations at scientific conferences and publications in peer-reviewed journals.
The new, low-cost supervised rehabilitation programmes are expected to present positive results, making PR programmes more accessible and effective for patients with COPD.
The study was registered in the Chinese Clinical Trial Registry: ChiCTR2000040723.
慢性阻塞性肺疾病(COPD)主要表现为运动性呼吸困难,这可能导致活动量减少。肺康复(PR)被认为能够减轻这些损害。然而,获得肺康复治疗的机会仅限于专业中心,尤其是在2019年冠状病毒病大流行期间。此外,低成本的家庭康复计划没有个性化的处方,这可能导致COPD患者的临床效果不一致。因此,制定新的、低成本的、涉及个性化处方和工作人员监督的方案很重要。
这是一项在天津某三甲医院进行的随机对照研究的描述性方案。样本量根据所述公式计算。将选取56名参与者并随机分为两组:(I)对照组(传统肺康复训练、药物治疗和护理干预);(II)干预组[通过心肺康复系统管理平台(CSM)在医院和家中进行肺康复训练]。该方案将在门诊每周进行两次,连续进行8周,训练将在试验的最后6个月通过应用CSM系统进行。该研究将评估肺功能和体能,并分析训练方案前后改良医学研究理事会呼吸困难量表、慢性阻塞性肺疾病评估测试、国际功能、残疾和健康分类以及6分钟步行测试的得分。差异比较将使用重复测量方差分析、线性混合效应分析或非参数检验,仅包括完成所有结局测量并遵循干预方案的参与者。研究结果将通过在科学会议上的报告和在同行评审期刊上发表来传播。
新的、低成本的监督康复计划有望呈现积极结果,使肺康复计划对COPD患者更易获得且更有效。
该研究已在中国临床试验注册中心注册:ChiCTR2000040723。