The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

IMPACT OF A PULMONARY REHABILITATION PROGRAM ON FUNCTIONAL CAPACITY, QUALITY OF LIFE, PERCEPTION OF DYSPNEA AND HEALTHCARE UTILIZATION.

Gretchen Horstman, RRT, RCP, Paul Tsivitse, MD, Department of Pulmonary Rehabilitation, Marymount Hospital, Garfield Heights, OH.

Background: Pulmonary Rehab has been shown to improve exercise capacity, desensitize participants to dyspnea and improve quality of life in individuals with chronic lung disease. The purpose of this study was to evaluate the effect of a Pulmonary Rehab Program on exercise capacity, quality of life (QOL), dyspnea and health care utilization. We hypothesized exercise capacity and QOL would increase, the perception of the severity of dyspnea and health care utilization would decrease post completion of Pulmonary Rehab. In order to evaluate the effectiveness of our program we followed 84 participants completing the Pulmonary Rehab Program at Marymount Hospital.

Methods: Graduates exercised twice a week for a total of 12 weeks, and were taught disease management education by a multi-disciplinary team of healthcare professionals. Participants had an average FEV1 of 1.2 L. (1STD 0.46) We measured participants exercise capacity on the treadmill and stationary bike, Quality Of Life (QOL) using SF-36 Health Survey, and Psychological General Well Being Index (PGWBI) Survey, dyspnea using University of California San Diego (UCSD) Shortness Of Breath (SOB) Questionnaire, pre and post program. We tracked 51 graduates (1995/1996) from the Rehab Program for 2 years (1 yr. pre/ 1 yr. post program). Graduates were followed tracking hospital admissions, LOS, and hospital charges generated while in the hospital.

Results: reported as average improvement in the chart below.

Mode Duration/Minute Intensity

s

Treadmill Walking 8.06 0.70 mph

Stationary Bicycle 6.66 8.61rpm

Survey Points Avg. Pre Points Avg.

Post

SF -36 Health Survey 87.40 102.19

PGWBI Survey 63.29 77.78

UCSD SOB Survey 59.09 48.21

Graduates Hosp. Hosp. Days LOS

1995/1996 Admits

1 yr. pre Rehab 32 199 7.37

1 yr. post Rehab 18 99 3.67

Differences (43% (50% (50%

Mode Distance/ Miles

Treadmill Walking 0.39

Stationary Bicycle 1.38

Survey N=number of

surveys

completed/returned

SF -36 Health Survey n = 21

PGWBI Survey n = 41

UCSD SOB Survey n = 34

Graduates Hosp. Charges

1995/1996 $274,383

1 yr. pre Rehab $145,352

1 yr. post Rehab $129,031

Differences

Conclusion: Our multidisciplinary Pulmonary Rehabilitation is effective in significantly improving the exercise capacity in patients with severe COPD, improves their perception of the impact of dyspnea on their activities of daily living, and improves QOL. Our Program reduced hospital admissions, shortened LOS, and reduced health care utilization in patients with severe COPD.

The 44th International Respiratory Congress Abstracts-On-DiskĀ®, November 7 - 10, 1998, Atlanta, Georgia.

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