The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

EFFECTS OF PULMONARY REHABILITATION IN PATIENTS WITH CHRONIC BRONCHIAL ASTHMA

Tetsuo Miyagawa Ph D, RRT, RPT, RCET, Showa University, College of Medical Sciences, Dept. of Physical Therapy, Yokohama, Japan. Hideko Kobayashi MD, and Norio Kihara MD, Dept. of Pulmonary Medicine, Kihara Hospital, Tokyo, Japan.

Introduction: Pulmonary rehabilitation have been shown to reduce dyspnea, increase exercise capacity, reduce hospitalization, and improve quality of life in patients with COPD. However, previous studies have been relatively few about the effect of pulmonary rehabilitation in patients with chronic bronchial asthma. The purpose of our study was to evaluate the effect of pulmonary rehabilitation.

Methods: Seventeen patients with chronic bronchial asthma were entered in this study. All patients were very stable clinical course but not able to reach personal best peek flow in spite of the inhaled corticosteroids or beta-adrenergic brochodilators. They were treated the same medication before and after 6 weeks pulmonary rehabilitation program. They performed 1) relaxation techniques and diaphragmatic breathing (2 sessions of 10 minutes of training, daily), 2) respiratory muscle stretch gymnastic (3 sessions of 5 RMSG patterns 4 times each, daily), 3) upper extremity training (5 sessions of 10 repetitions of arm elevation against gravity with weights, daily), 4)exercise training (1 session of 20 minutes walking of the target speed, daily). Before and after data were evaluated with paired t tests. Two patients dropped out due to predetermined criteria.

Results: Results shown are mean value and 1 SD (n=15).

before after

Plmax (cmH_{2}O) 71.7±25.9 * 81.6±28.8

PEmax (cmH_{2}O) 69.2±24.0 ** 85.2±29.6

chest expansion (cm),lower chest 3.7 ±2.0 ** 6.2±2.0

wall

VC ( L ) 2.52±0.58 * 2.77±0.71

FVC ( L ) 2.39±0.61 ** 2.53±0.67

FEV_{1.0} ( L ) 1.52±0.57 * 1.60±0.60

FEV_{1.0%} (%) 62.6±11.9 60.4±12.7

MEFR ( L /sec) 0.99±0.68 1.03±0.79

PFR ( L /sec) 4.03±1.69 * 4.49±1.87

V_{25} ( L /sec) 0.40±0.29 0.41±0.32

R_{aw} (cmH_{2}O/ L /sec) 6.95±1.78 7.23±1.49

6-min walking distance (6MD) (m) 313.3±65.0 ** 348.7±71.9

(*, P < 0.05; **, P < 0.01 comparing values before and after rehabilitation)

Almost all the patients were reduced dyspnea and asthma attack, and improved HRQL.

Conclusion: The results suggest that pulmonary rehabilitation were effective for chest wall stiffness, respiratory muscle strength, exercise tolerance and HRQL in patients with chronic bronchial asthma. Pulmonary rehabilitation were also improved lung volume but not obstruction of the airway.

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

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