Annual General Meeting of the Irish Thoracic Society - IJMS | Irish ...

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SESSION THREE ONE
ANNUAL MEETING OF THE IRISH THORACIC SOCIETY • 11 - 12 November 2005 • WESTWOOD HOUSE HOTEL, GALWAY
ANNUAL MEETING OF THE IRISH THORACIC SOCIETY • 11 - 12 November 2005 • WESTWOOD HOUSE HOTEL, GALWAY
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SESSION
SESSION THREE ONE
3.5
Setting up a pulmonary rehabilitation programme
Background
Pulmonary rehabilitation for patients with chronic
pulmonary disease is cost-effective, improves
quality of life, increases exercise capacity and
reduces exacerbations and inpatient admissions. We
sought to establish a pilot pulmonary rehabilitation
programme in our institution.
Methods
We researched the literature on the methods used in
other centres, and visited an established program in
another Irish hospital. Six patients were enrolled to
the pilot group: 5 had COPD; 1 had asthma. Baseline
demographic and anthropometric data were gathered.
Pulmonary function, respiratory muscle strength and
exercise capacity were assessed. Symptoms were
evaluated using published respiratory questionnaires.
Participants attended 16 sessions over 8 weeks,
comprising biweekly exercise sessions, supervised by
the physiotherapist, and weekly lectures from medical,
paramedical and nursing staff.
Results
Attendance was 100% with 98% completion of
sessions. Patients had improvements in respiratory
symptoms and symptoms of anxiety and depression,
3.6
Prolonged pulonary rehabilitation may lead to greater
improvements in exercise capacity and health related
quality of life in COPD
Background
BTS guidelines recommend pulmonary rehabilitation
(PR) for patients with COPD. The optimum number of
training sessions has not been established.
Methods
Three outpatient PR programmes of 8, 12 or 16
sessions, over 6 to 8 weeks, were conducted using
standardized local guidelines. Patients with stable
chronic respiratory disease were prospectively
as measured by the St. Georges Respiratory, Chronic
Respiratory Disease and Hospital Anxiety and
Depression Questionnaires. Most strikingly, exercise
capacity increased dramatically after completion of
the programme (40% increase in Shuttle Walking
Test and 68.6% increase in Treadmill distances).
Conclusions
The pilot study showed that results reported in
international studies of pulmonary rehabilitation
can be reproduced in an Irish hospital setting.
Extrapolating our results into the future, we can
expect significant, cost-effective improvements in
morbidity, mortality and acute hospital admissions.
recruited. The ISWT (incremental shuttle walk test)
and SR-CRQ (self-reporting chronic respiratory
questionnaire) were used to assess exercise capacity
and quality of life pre and post programme.
Results
126 patients were included, matched between
programmes for age, sex, lung function and baseline
ISWT distance. Outcome results are expressed as a
median.
PROGRAMME NUMBER
INCREASE
CHANGE IN SR-CRQ
IN ISWT DYSPNOEA FATIQUE EMOTION MASTERY
A: 8 sessions 40 5 metres 0.60 0.75 0.40* 0.00*
B: 12 sessions 42 55 metres† 0.70 1.25 0.80 1.00
C: 16 sessions 44 90 metres† 0.60 0.65 0.86 0.75
R O’Farrell,
A O’Mahony,
A Donnelly, N Brennan,
TM O’Connor
Mercy University
Hospital, Cork
CA Moore, L Emmett,
A Jones, T Platten,
PK Plant, MT Henry
Dept of Respiratory
Medicine, Leeds
General Infirmary, UK
3.7
Increase in ISWT distance was highly significant in
programmes B and C (p