Wijkstra P J, Van Altena R, Kraan J, Otten V, Postma D S, Koëter G H
Asthma Centre Beatrixoord, Haren, The Netherlands.
Eur Respir J. 1994 Feb;7(2):269-73. doi: 10.1183/09031936.94.07020269.
We have developed a rehabilitation programme at home and have investigated its effects on quality of life (QOL), lung function, and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). We studied 43 patients with severe airflow obstruction: forced expiratory volume in one second (FEV1) 1.3 +/- 0.4 l (mean +/- SD), FEV1/inspiratory vital capacity (IVC) 37 +/- 7.9%. After stratification, 28 patients were randomly allocated in a home rehabilitation programme for 12 weeks. Fifteen patients in a control group received no rehabilitation. The rehabilitation group received physiotherapy by the local physiotherapist, and supervision by a nurse and a general practitioner. Quality of life was assessed by the four dimensions of the Chronic Respiratory Questionnaire (CRQ). We found a highly significant improvement in the rehabilitation group compared to the control group for the dimensions dyspnoea, emotion, and mastery. Lung function showed no changes in the rehabilitation group. The exercise tolerance improved significantly in the rehabilitation group compared to the control group. The improvement in quality of life was not correlated with the improvement in exercise tolerance. Rehabilitation of COPD patients at home may improve quality of life; this improvement is not correlated with an improvement in lung function and exercise tolerance.
我们制定了一项居家康复计划,并研究了其对慢性阻塞性肺疾病(COPD)患者生活质量(QOL)、肺功能和运动耐力的影响。我们研究了43例严重气流受限患者:一秒用力呼气容积(FEV1)为1.3±0.4升(平均值±标准差),FEV1/吸气肺活量(IVC)为37±7.9%。分层后,28例患者被随机分配至居家康复计划中,为期12周。15例对照组患者未接受康复治疗。康复组接受当地物理治疗师的物理治疗,并由一名护士和一名全科医生进行监督。生活质量通过慢性呼吸问卷(CRQ)的四个维度进行评估。我们发现,与对照组相比,康复组在呼吸困难、情绪和掌控感维度上有非常显著的改善。康复组的肺功能没有变化。与对照组相比,康复组的运动耐力有显著提高。生活质量的改善与运动耐力的提高无关。COPD患者的居家康复可能会改善生活质量;这种改善与肺功能和运动耐力的改善无关。