RESUMEN
BACKGROUND: Pulmonary rehabilitation has shown significant benefit for patients with chronic obstructive pulmonary disease (COPD). The effect on non-COPD pulmonary patients is less well established. OBJECTIVES: To determine whether pulmonary rehabilitation is also beneficial for non-COPD pulmonary patients. METHODS: Clinical and demographic data on non-COPD pulmonary patients who participated in our institutional pulmonary rehabilitation program between January 2009 and December 2016 were collected. Participants engaged in a 60-minute, twice-weekly, ambulatory hospital-based program lasting 12 to 24 sessions. Sessions included both endurance and muscle training as well as healthy lifestyle educational activities. The six-minute walk test (6MWT) and the St. George's Respiratory Questionnaire (SGRQ) were conducted before and after the rehabilitation program. RESULTS: We recruited 214 non-COPD patients, of whom 153 completed at least 12 sessions. Of these, 59 presented with interstitial lung disease (ILD), 18 with non-ILD restrictive lung defects, 25 with asthma, 30 with lung cancer, and 21 with other conditions (e.g., pulmonary hypertension, bronchiectasis) The groups demonstrated significant improvement in 6MWT and in SGRQ scores. Non-COPD patients gained a 61.9 meter (19%) improvement in the 6MWT (P < 0.0001) and 8.3 point reduction in their SGRQ score (P < 0.0001). CONCLUSIONS: Pulmonary rehabilitation is effective in non-COPD pulmonary patients. As such, it should be an integral part of the treatment armament provided to the vast majority of those suffering from chronic respiratory disease.
Asunto(s)
Disnea , Terapia por Ejercicio/métodos , Enfermedades Pulmonares , Calidad de Vida , Anciano , Disnea/etiología , Disnea/fisiopatología , Disnea/psicología , Disnea/rehabilitación , Entrenamiento Aeróbico/métodos , Femenino , Humanos , Enfermedades Pulmonares/clasificación , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/psicología , Enfermedades Pulmonares/rehabilitación , Masculino , Persona de Mediana Edad , Ejercicios de Estiramiento Muscular/métodos , Encuestas y Cuestionarios , Resultado del Tratamiento , Prueba de Paso/métodosRESUMEN
INTRODUCTION: Pulmonary rehabilitation is regarded as a crucial component of the therapeutic armamentarium in chronic lung disease. Ten years ago the Pulmonary Rehabilitation Service at the Shaare Zedek Medical Center (SZMC) was established as part of the Cardiac Rehabilitation Center. Over the last six years this service operates independently within the physiotherapy center under the supervision of the Pulmonary Institute, in collaboration with the social and nutritional services. AIMS: To evaluate the efficacy of pulmonary rehabilitation in improving the patients' quality of life and functional capacity. METHODS: Prospective follow-up of patients referred for pulmonary rehabilitation at the SZMC between the years 2009-2013. The participants were required to complete a pulmonary function test, a 6 minute walk test (6MWT) and a quality of life questionnaire, the Saint George Respiratory Questionnaire (SGRQ). The SGRQ and the 6MWT were readministered after completion of the program. RESULTS: During the follow-up period 415 patients underwent pulmonary rehabilitation at SZMC, of them 330 completed a series of at least 12 sessions. Complete data pertaining to the 6MWTwas obtained for 276 subjects. Participation in the program led to an improvement of 57.5 meters (p < 0.001) in the walking distance. Complete data regarding the SGRQ were available for 94 patients. Completion of the pulmonary rehabilitation program led to a decrease of 8.9 points in the SGRQ (p < 0.001). CONCLUSIONS: Our results indicate that pulmonary rehabilitation was clinically useful as well as statistically significant in improving the functional capacity and quality of life among patients with chronic lung diseases.