Weiser P C, Ryan K P
Department of Medicine, Medical College of Pennsylvania and Hahnemann University, Philadelphia, USA.
J Cardiopulm Rehabil. 1996 May-Jun;16(3):175-82. doi: 10.1097/00008483-199605000-00005.
This report analyzes the delivery of exercise conditioning services in the 1991 Pennsylvania, New Jersey, and Delaware regional survey of pulmonary rehabilitation programs.
Data from a questionnaire was analyzed with special consideration given to whether the program provided services for patients with only pulmonary diseases (n = 41) or with cardiac and pulmonary diseases (n = 18).
All 59 programs included exercise conditioning. Most programs (67%) used oxygen saturation and/or expired gas analysis for writing exercise prescriptions. Only pulmonary programs used 6- or 12-minute walk data. The exercise prescription was written by nonphysicians in 51% of the programs. Most pulmonary-only programs used respiratory therapists by themselves or in combination with other professionals as exercise supervisors (71%). Cardiopulmonary programs used exercise physiologists by themselves (22%) or nurses by themselves or in combination with other professionals (50%). For all programs, the standard for ratio of patients to exercise staff averaged 3.0:1. Pulmonary-only programs did slightly but significantly more continuous arterial oxygen percent saturation (SaO2) monitoring rather than spot checking. A standard determining the use of supplemental oxygen during exercise was reported by 78% of all programs. Most used supplemental oxygen after observing the SaO2 level falling to < 90%. Electrocardiograph monitoring was done in 66% of pulmonary-only programs, but in 94% of the cardiopulmonary programs. Maintenance sessions were offered by 64% of the pulmonary-only programs and also by 78% of the cardiopulmonary programs.
The type of rehabilitation program, either pulmonary-only or cardiopulmonary, appears to influence the exercise conditioning services used by the pulmonary patient.
本报告分析了1991年宾夕法尼亚州、新泽西州和特拉华州地区肺康复项目调查中运动调节服务的提供情况。
对一份调查问卷的数据进行分析，特别考虑该项目是只为患有肺部疾病的患者（n = 41）还是为患有心脏和肺部疾病的患者（n = 18）提供服务。
所有59个项目都包括运动调节。大多数项目（67%）使用血氧饱和度和/或呼出气体分析来制定运动处方。只有肺部疾病项目使用6分钟或12分钟步行数据。在51%的项目中，运动处方由非医生撰写。大多数仅针对肺部疾病的项目单独使用呼吸治疗师或与其他专业人员联合作为运动监督人员（71%）。心肺疾病项目单独使用运动生理学家（22%）或单独使用护士或与其他专业人员联合（50%）。对于所有项目，患者与运动工作人员的比例标准平均为3.0:1。仅针对肺部疾病的项目进行持续动脉血氧饱和度（SaO2）监测的次数略多但显著多于随机检查。78%的所有项目报告了确定运动期间使用补充氧气的标准。大多数在观察到SaO2水平降至<90%后使用补充氧气。66%的仅针对肺部疾病的项目进行心电图监测，但在心肺疾病项目中这一比例为94%。64%的仅针对肺部疾病的项目以及78%的心肺疾病项目提供维持课程。
康复项目的类型，无论是仅针对肺部疾病还是心肺疾病，似乎都会影响肺部疾病患者所接受的运动调节服务。
