PURPOSE: It is very important to evaluate the degree of disability in subjects with RF who are characterized by high dependency rate. On the other hand, one of the aim of pulmonary rehabilitation is to decrease healthcare resources utilisation.
METHODS: The aim of our study was to evaluate the efficacy of PR in patients with severe RF using FIM scale that measures the degree of disability experienced by patients and the progress they make during rehabilitation. It includes several items: self care (SC), mobility (M), locomotion (L), communication (C) and social recognition (SR). Twenty-two patients with RF undergoing long-term oxygen therapy (age range 70.36 1.58 yrs, PO2 58.18 7.63 mmHg, PCO2 46.82 9.11mmHg) were studied. An iPR programme of three weeks including upper and lower limbs exercise training, respiratory muscle stretch, nocturnal non invasive mechanical ventilation, mucus evacuation techniques, and relaxation techniques was performed. FIM, Medical Research Council Dyspnoea scale (MRC), St George Respiratory Questionnaire (SGRQ), and 6-Minutes Walking Distance (6-MWD), were administered on admission and discharge from iPR. Wilcoxon Rank Test and Spearman Test were used.
RESULTS: After iPR there was a statistically significant improvement in all FIM items: total score (p=0.000), SC (p=0.000), M (p=0.006), L (p=0.000), SC (p=0.027) except for C (n.s.). Other outcomes results were: MRC (pre 14.32 0.84; post 3.00 1.15, p=0.000). SGRQ (%) (pre 69.86 4.62 ; post 46.50 11.94, p=0.000) ; 6-MWD (pre 164.54 98.63; post 214.32 97.64, p=0.000).A negative correlation was also observed between MRC and FIM (r=- 0.5042 p= 0.016).
CONCLUSION: Our study confirmed the benefits of iPR in subjects with RF as it translates not only in dyspnoea, exercise capacity and quality of life but also with regards to neuromotor disabilities well expressed by FIM.
CLINICAL IMPLICATIONS: Our results encourage future studies using FIM, in subjects undergoing inpatient pulmonary rehabilitation with respiratory failure who are high dependency patients with dramatic health system costs.
DISCLOSURE: Gian Luca Biscione, None.