An integral part of the comprehensi...

An integral part of the comprehensive care commited for patients with chronic obstructive pulmonary disease (COPD) is a pulmonary rehabilitation program. Various studies have demonstrated that these programs are effective in reducing symptoms of dyspnea, and improving exercise capacity and quality of life in patients with COPD The now passing recommendation for these programs is that they take a multidisciplinary approach to the care of these patients. of the like kind programs require a significant amount of resources and circulating medium Hui and Hewitt developed a simple outpatient pulmonary rehabilitation program that consisted of incremental exercise endurance training, upper- and lower-limb weight training, and endurance activities. The team involved in this program included a physiotherapist supervised by dint of a respiratory physician. Hui and Hewitt hypothesized that this simple pulmonary rehabilitation program could improve health issues and reduce hospital use in patients with COPD

Patients with a diagnosis of COPD and a forced expiratory bulk in one second of les than 60 percent predicted or exertional limitations secondary to dyspnea were recorded in this prospective, longitudinal trial. The program consisted of endurance training that started with walking, movement forwarded to bicycle ergometer and, if appropriate, to grades and jogging on a mini-trampoline. Upper- and lower-limb weight training started at week 3 of the program. No other formal support was provided, and no other allied health professional was involved in the program.

Baseline evaluation of the patients included spirometry, a six-minute walking distance assessment, Borg dyspnea scale after the six-minute walk, and a quality-of-life assessment using the chronic respiratory disease questionnaire. These evaluations were repeated common week after completion of the program. Hospitalization and fulness of stay for the participants were assessed for single in kind year before the study and for common year after the program was complet The researchers included merely hospital stays that were directly related to exacerbation of COPD

Thirty-six patients complet the meditation Those who participated had a significant improvement in exercise endurance, with the average six-minute walking distance improving from 333 m at the start of the program to 423 m at the completion of the program. They also had a significant reduction in dyspnea scores and improvement in quality-of-life scores. There was no change in lung function at the fall of the curtain of the study compared with baseline readings. The number of hospital admissions was reduc significantly when the year before the meditation was compared with the year after completion of the application of mind In addition, the average amplification of hospital stay was reduc significantly from 74 days before the program to 33 days after the program was completed

The authors close that a simple, low-cost, outpatient pulmonary rehabilitation program can improve health results in patients with COPD. They add that this program was shown to improve health consequences and reduce hospitalizations and average duration of stays. The program also could help abate the cost of caring for patients with COPD

Hui KP Hewitt AB. A simple pulmonary rehabilitation program improves health consequences and reduces hospital utilization in patients with COPD Chest July 2003;124:94-7

COPYRIGHT 2004 American Academy of Family Physicians

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