To study the efficacy of a short intensive pulmonary rehabilitation program on the exercise capacity, dyspnea and quality of life (QOL) in patients with chronic respiratory diseases.
This study was conducted from October 2003 to March 2004 in a tertiary referral center where patients who were referred for pulmonary rehabilitation were offered an intensive inpatient program if they were not able to attend the regular 6-week outpatient program. All patients underwent lung function tests, 6-minute walk test, cardiopulmonary exercise test (if able to do so) as well as 2 QOL questionnaires on admission –these were repeated on completion of the program. Each patient underwent 2 sessions of physical therapy (including inspiratory muscle training) daily, for a total of 18 sessions over the 16 days of hospital stay. Each session consisted of a 5-minute warm-up, 30 to 40 minutes of aerobic exercises, and strengthening exercises using elasticity-graduated Theraband and free weights. Oxygen was administered to keep hemoglobin saturation above 90%.
Twelve male patients (8 with COPD, 2 with bronchiectasis, 2 with interstitial fibrosis) aged 64.5±14.5 (mean±SD) years were recruited. The results of paired analysis of data from these patients are shown in the tableVariables (units)NumberMean change ± SDSignificance (2-tailed)MIP (kPascal)90.95±1.870.575MEP(kPascal)90.14±1.370.674Max. VO2 (ml/kg/min)52.2±0.80.043Work rate (W)94±110.400Max. ventilation (L/min)511.6±17.10.043Borg scale92.7±2.30.0266-min walk test (m)1229.5±44.40.033CRDQ-Total score1213.8±12.40.003SGRQ-Total score1210.10±9.220.003, with p<0.05 considered signficant. Improvement was seen in exercise capacity, minute ventilation, QOL and dyspnea scores but not respiratory muscle strength.
We conclude that a short 18-session intensive pulmonary rehabilitation program is able to improve exercise capacity, dyspnea and QOL of patients with chronic respiratory diseases.
In our country where many of our patients find it logistically difficult to travel 3 times a week to an oupatient facility for 6-8 weeks of pulmonary rehabilitation because of caregiver and transportation issues, this intensive inpatient pulmonary rehabilitation program may be offered as an alternative. Whether its efficacy is equivalent to the usual 6-8 week program requires further study.
C. Loo, None.