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肺移植中团队康复与个体康复的比较:一项回顾性非劣效性评估

Group Versus Individual Rehabilitation in Lung Transplantation: A Retrospective Noninferiority Assessment.

作者信息

Byrd Rebecca, Breslin Rachel, Wang Peijin, Peskoe Sarah, Chow Shein-Chung, Lowers Sean, Snyder Laurie D, Pastva Amy M

机构信息

Department of Cardiology, Duke University Health System, Durham, NC.

Department of Biostatistics and Bioinformatics, Duke University, Durham NC.

出版信息

Cardiopulm Phys Ther J. 2024 Jan;35(1):28-36. doi: 10.1097/cpt.0000000000000233.

Abstract

PURPOSE

Pulmonary rehabilitation both before and after lung transplant is associated with improved functional exercise capacity and physical quality of life. There is wide variation in rehabilitation program provision. This study's aim was to compare the effects of group versus individual rehabilitation.

METHODS

Individuals who completed pre- and/or posttransplant outpatient rehabilitation at a single, academic, medical center between March 2019 and March 2021 were included in this study. Noninferiority analysis was used to assess differences in change in 6-minute walk distance (6MWD) between group and individual rehabilitation. Multivariable linear regression models examined 6MWD, Short Physical Performance Battery (SPPB), Ferrans and Powers Quality of Life Index Pulmonary Version (QLI), Center for Epidemiological Studies-Depression Scale (CESD), and San Diego Shortness of Breath Questionnaire (SOBQ).

RESULTS

Preoperatively, 93 patients completed group and 81 completed individual rehabilitation. Postoperatively, 110 completed group and 105 completed individual rehabilitation. Individual rehabilitation was noninferior to group rehabilitation (a 5 0.05). In addition, there was no significant difference in changes in 6MWD, SPPB, QLI, CESD, or SOBQ, between cohorts pre- and postoperatively (all .25).

CONCLUSIONS

Individual rehabilitation seems to be an acceptable alternative to group rehabilitation for lung transplant candidates and recipients.

摘要

目的

肺移植前后的肺康复与功能运动能力和身体生活质量的改善相关。康复计划的提供存在很大差异。本研究的目的是比较团体康复与个体康复的效果。

方法

纳入2019年3月至2021年3月期间在单一学术医疗中心完成移植前和/或移植后门诊康复的个体。采用非劣效性分析评估团体康复与个体康复之间6分钟步行距离(6MWD)变化的差异。多变量线性回归模型研究了6MWD、简短身体功能测试(SPPB)、费兰斯和鲍尔斯生活质量指数肺部版(QLI)、流行病学研究中心抑郁量表(CESD)以及圣地亚哥呼吸急促问卷(SOBQ)。

结果

术前,93例患者完成团体康复,81例完成个体康复。术后,110例完成团体康复,105例完成个体康复。个体康复不劣于团体康复(α = 0.05)。此外,术前和术后队列之间的6MWD、SPPB、QLI、CESD或SOBQ变化无显著差异(均P>.25)。

结论

对于肺移植候选者和接受者,个体康复似乎是团体康复的可接受替代方案。

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